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Postmortem PF4 antibodies confirm a rare case of thrombosis thrombocytopenia syndrome associated with ChAdOx1 nCoV-19 anti-COVID vaccination.
Alunni, V; Bernardi, C; Chevalier, N; Cabusat, C; Quatrehomme, G; Torrents, J; Biglia, E; Gaillard, Y; Drici, M-D.
  • Alunni V; Institut Universitaire d'Anthropologie Médico-Légale, Faculté de Médecine, Université Côte d'Azur, 28 Avenue de Valombrose, 06107, Nice, France. alunni.v@chu-nice.fr.
  • Bernardi C; CEPAM (UMR CNRS 7264), 24 Avenue Des Diables Bleus, 06300, Nice, France. alunni.v@chu-nice.fr.
  • Chevalier N; Institut Universitaire d'Anthropologie Médico-Légale, Faculté de Médecine, Université Côte d'Azur, 28 Avenue de Valombrose, 06107, Nice, France.
  • Cabusat C; CEPAM (UMR CNRS 7264), 24 Avenue Des Diables Bleus, 06300, Nice, France.
  • Quatrehomme G; Université Côte d'Azur, INSERM U1065, C3M, 06107, Nice, France.
  • Torrents J; Centre Hospitalier Universitaire de Nice, Endocrinology and Diabetologia Department, Université Côte d'Azur, Hopital L'Archet 2 Hospital, 151 Route Saint Antoine, 06200, Nice, France.
  • Biglia E; Institut Universitaire d'Anthropologie Médico-Légale, Faculté de Médecine, Université Côte d'Azur, 28 Avenue de Valombrose, 06107, Nice, France.
  • Gaillard Y; Institut Universitaire d'Anthropologie Médico-Légale, Faculté de Médecine, Université Côte d'Azur, 28 Avenue de Valombrose, 06107, Nice, France.
  • Drici MD; CEPAM (UMR CNRS 7264), 24 Avenue Des Diables Bleus, 06300, Nice, France.
Int J Legal Med ; 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2227419
ABSTRACT
We report a case of cerebral venous sinus thrombosis, bilateral adrenal hemorrhage, and thrombocytopenia in a 70-year-old man found dead. He had previously received the ChAdOx1 nCoV-19 vaccine (Vaxzevria®, AstraZeneca) 18 days before, and had since developed unspecific and undiagnosed characteristics of what proved to be a rare case of vaccine-associated thrombocytopenia with thrombosis syndrome (TTS). He was found dead 1 week after the beginning of symptoms (day 25 post-vaccine). Autopsy yielded venous hemorrhagic infarction with the presence of thrombi within dural venous sinuses, and extensive hemorrhagic necrosis of the central part of the adrenal glands. Antibodies against platelet factor 4 (PF4) were strongly positive in postmortem fluids, as measured with an enzyme-linked immunosorbent assay (ELISA). This difficult diagnosis is usually made during the patient's lifetime. After eliminating differential diagnoses, we concluded on a fatal case of vaccine-induced immune TTS with positive anti-PF4 antibodies in cadaveric blood, 3 weeks after ChAdOx1 nCoV-19 vaccination. Specific search for anti-PF4 antibodies in cadaveric blood appears therefore paramount to assess postmortem cases of TTS associated with anti-COVID vaccines.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study Topics: Vaccines Language: English Journal subject: Jurisprudence Year: 2022 Document Type: Article Affiliation country: S00414-022-02910-1

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study Topics: Vaccines Language: English Journal subject: Jurisprudence Year: 2022 Document Type: Article Affiliation country: S00414-022-02910-1