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VITT following Ad26.COV2.S vaccination presenting without radiographically demonstrable thrombosis.
Kennedy, Vanessa E; Wong, Chelsea C; Hong, Jessica M; Peng, Theodore; Brondfield, Sam; Reilly, Linda M; Cornett, Patricia; Leavitt, Andrew D.
  • Kennedy VE; Division of Hematology/Oncology, Department of Medicine.
  • Wong CC; Division of Hematology/Oncology, Department of Medicine.
  • Hong JM; School of Medicine.
  • Peng T; School of Medicine.
  • Brondfield S; Division of Hematology/Oncology, Department of Medicine.
  • Reilly LM; Department of Surgery, and.
  • Cornett P; Division of Hematology/Oncology, Department of Medicine.
  • Leavitt AD; Division of Hematology/Oncology, Department of Medicine.
Blood Adv ; 5(22): 4662-4665, 2021 11 23.
Article in English | MEDLINE | ID: covidwho-1443790
ABSTRACT
We report a case of vaccine-induced immune thrombotic thrombocytopenia (VITT) in a young man diagnosed 13 days after Ad26.COV2.S COVID-19 (Johnson & Johnson/Janssen) vaccination. He presented to us with 5 days of progressive left leg pain, thrombocytopenia, hypofibrinogenemia, and markedly elevated d-dimers, but without radiographically demonstrable thrombosis. Despite negative imaging, we initiated treatment of presumptive VITT given the striking clinical picture that included the timing of his recent adenovirus-based COVID-19 vaccine, leg symptoms, marked thrombocytopenia, and consumptive coagulopathy. He received intravenous immune globulin, prednisone, and argatroban and was discharged 7 days later much improved. His positive platelet factor 4 enzyme-linked immunosorbent assay antibody test returned after treatment was initiated. To our knowledge, this is the first reported case of VITT following Ad26.COV2.S vaccination presenting without radiographically demonstrable thrombosis. Our patient highlights the importance of knowing vaccine status and initiating treatment as soon as possible in the right clinical setting, even in the absence of radiographic evidence of thrombus. Early VITT recognition and treatment provide an opportunity to prevent serious thrombotic complications.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Thrombosis / COVID-19 Vaccines / COVID-19 Type of study: Case report / Observational study / Prognostic study Topics: Vaccines Limits: Humans / Male Language: English Journal: Blood Adv Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Thrombosis / COVID-19 Vaccines / COVID-19 Type of study: Case report / Observational study / Prognostic study Topics: Vaccines Limits: Humans / Male Language: English Journal: Blood Adv Year: 2021 Document Type: Article