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Late-Onset Vaccine-Induced Immune Thombotic Thrombocytopenia (VITT) with Cerebral Venous Sinus Thrombosis.
Saleh, Maruan; Zimmermann, Julian; Lehnen, Nils C; Pötzsch, Bernd; Weller, Johannes M.
  • Saleh M; Department of Neurology, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany.
  • Zimmermann J; Department of Neurology, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany.
  • Lehnen NC; Department of Neuroradiology, University Hospital Bonn, Bonn, Germany; Research Group Clinical Neuroimaging, German Center for Neurodegenerative Diseases, Bonn, Germany.
  • Pötzsch B; Institute of Experimental Hematology and Transfusion Medicine, University of Bonn, Bonn, Germany.
  • Weller JM; Department of Neurology, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany. Electronic address: Johannes.Weller@ukbonn.de.
J Stroke Cerebrovasc Dis ; 31(4): 106311, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1654846
ABSTRACT

OBJECTIVES:

Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare complication after adenoviral vector vaccination against COVID-19 reported up to 24 days after ChAdOx1 nCOV-19 (AZD1222) vaccination. This report describes a case with a significantly later onset of VITT with cerebral venous sinus thrombosis. CASE DESCRIPTION We report a 42-year-old woman presenting to the emergency department 53 days after AZD1222 vaccination with sudden onset sensory aphasia and an 18-day history of headache. Cranial computed tomography (CT) showed acute intracranial hemorrhage and CT venogram demonstrated thrombosis of the left vein of Labbé and transverse and sigmoid sinus. D-dimers were elevated and despite a normal platelet count, platelet-activating anti-PF4 antibody testing was positive, confirming the diagnosis of VITT. The patient was treated with intravenous immunoglobulins and argatroban, and was discharged without any neurological deficit on day 12.

CONCLUSION:

Our report of VITT with symptom onset on day 35 and diagnosis of cerebral sinuous thrombosis on day 53 after AZD1222 vaccination significantly enhances the time window during which VITT may occur.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinus Thrombosis, Intracranial / Thrombocytopenia / Vaccines / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Female / Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2022 Document Type: Article Affiliation country: J.jstrokecerebrovasdis.2022.106311

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinus Thrombosis, Intracranial / Thrombocytopenia / Vaccines / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Female / Humans Language: English Journal: J Stroke Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2022 Document Type: Article Affiliation country: J.jstrokecerebrovasdis.2022.106311