Vaccine-induced massive pulmonary embolism and thrombocytopenia following a single dose of Janssen Ad26.COV2.S vaccination.

Autor:	Curcio R; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Gandolfo V; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Alcidi R; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Giacomino L; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Emergency, 'Santa Maria' Terni University Hospital, Terni, Italy., Campanella T; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Casarola G; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Rossi R; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Chiatti L; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., D'Abbondanza M; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy., Commissari R; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Emergency, 'Santa Maria' Terni University Hospital, Terni, Italy., Gresele P; Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Pucci G; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy. Electronic address: giacomo.pucci@unipg.it., Vaudo G; Department of Medicine and Surgery, University of Perugia, Perugia, Italy; Unit of Internal Medicine, 'Santa Maria' Terni University Hospital, Terni, Italy.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2022 Mar; Vol. 116, pp. 154-156. Date of Electronic Publication: 2022 Jan 02.
DOI:	10.1016/j.ijid.2021.12.345
Abstrakt:	Vaccine-induced immune thrombotic thrombocytopenia (VITT) has emerged as a rare side effect of adenoviral vector-based vaccines against coronavirus disease 2019 (COVID-19), and is most frequently reported after use of the Vaxzevria (AstraZeneca) vaccine. This report describes a case of severe thrombocytopenia associated with massive pulmonary embolism and portal vein thrombosis occurring 13 days after the administration of the single-dose adenoviral vector-based vaccine Ad26.COV2.S (Janssen Vaccines). Based on early clinical suspicion, the patient quickly received treatment with corticosteroids and intravenous immunoglobulin, followed by a rapid increase in platelet count that allowed timely administration of full-dose anticoagulation. Treatment with intravenous immunoglobulin, however, could mask the ability of anti-platelet factor 4-heparin antibodies to bind and activate platelets in the presence of heparin, leading to false-negative results on the immunoassay functional test. Therefore, if VITT is suspected, blood samples for diagnostic confirmation should be collected prior to any treatment to improve diagnostic performance. Competing Interests: Conflict of interest statement None declared. (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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