A cluster of pediatric vaccine-induced immune thrombotic thrombocytopenia-like cases with thrombosis and thrombocytopenia following respiratory infections-case series.

Autor: Dimopoulou D; 2nd Department of Pediatrics, 'Aghia Sofia' Children's Hospital, Athens, Greece., Mentesidou L; 1st Department of Pediatrics, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece., Dettoraki A; Haemophilia Centre for Children and Adolescents/Haemostasis and Thrombosis Unit, 'Aghia Sofia' Children's Hospital, Athens, Greece., Karastathi C; 2nd Department of Pediatrics, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece., Berikopoulou M; 2nd Department of Pediatrics, 'Aghia Sofia' Children's Hospital, Athens, Greece., Katsouli P; 1st Department of Pediatrics, National and Kapodistrian University of Athens, 'Aghia Sofia' Children's Hospital, Athens, Greece., Anastasopoulou I; Hemostasis Department, Laikon General Hospital, Athens, Greece., Stamatakis IG; Department of Pediatric Neurology, 'Aghia Sofia' Children's Hospital, Athens, Greece., Bachou T; 1st Department of Pediatrics, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece., Tzifi F; 2nd Department of Pediatrics, 'P. & A. Kyriakou' Children's Hospital, Athens, Greece., Michalopoulou A; Haemophilia Centre for Children and Adolescents/Haemostasis and Thrombosis Unit, 'Aghia Sofia' Children's Hospital, Athens, Greece., Messaritaki A; 2nd Department of Pediatrics, 'Aghia Sofia' Children's Hospital, Athens, Greece., Spoulou V; 1st Department of Pediatrics, National and Kapodistrian University of Athens, 'Aghia Sofia' Children's Hospital, Athens, Greece., Pergantou H; Haemophilia Centre for Children and Adolescents/Haemostasis and Thrombosis Unit, 'Aghia Sofia' Children's Hospital, Athens, Greece.
Jazyk: angličtina
Zdroj: Research and practice in thrombosis and haemostasis [Res Pract Thromb Haemost] 2024 Oct 10; Vol. 8 (7), pp. 102589. Date of Electronic Publication: 2024 Oct 10 (Print Publication: 2024).
DOI: 10.1016/j.rpth.2024.102589
Abstrakt: Background: Adenoviral vector COVID-19 vaccine-induced immune thrombotic thrombocytopenia (VITT) is a heparin-independent platelet-activating disorder. An increasing number of VITT-like disorders without previous vaccination are being identified.
Key Clinical Question: To explore the association of the pediatric cluster of postinfectious thrombosis and thrombocytopenia with VITT-like disorders.
Clinical Approach: Three children with severe thrombocytopenia, coagulopathy, elevated D-dimer, and thrombotic events (cerebral venous sinus thrombosis) were reported. Two had positive nasopharyngeal samples for adenovirus, and 1 had group A streptococcus infection. They all had a COVID-19 history and low-risk antiphospholipid syndrome. Heterozygosity for factor V Leiden was found in 2 children. In 2 patients for whom anti-platelet factor 4 (PF4) serology was performed, positive results were found by PF4/polyanion lateral-flow immunoassay but negative results by PF4/polyanion chemiluminescence immunoassay. All patients were treated with enoxaparin or fondaparinux and intravenous immunoglobulin, while 3 received platelets transfusion and steroids.
Conclusion: This cluster of pediatric cases with thrombosis and thrombocytopenia may indicate a postinfectious (most notably, postadenovirus) VITT-like disorder.
(© 2024 The Authors.)
Databáze: MEDLINE
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