Vaccine-induced immune thrombotic thrombocytopenia
Douglas B. Cines, Andreas Greinacher
Abstract
Within the first months of the COVID-19 vaccination campaign, previously healthy recipients who developed severe thrombosis (often cerebral and/or splanchnic vasculature) and thrombocytopenia typically after adenoviral vector-based vaccination were identified. Similarities between this syndrome, vaccine-induced immune thrombotic thrombocytopenia (VITT), and heparin-induced thrombocytopenia prompted recognition of the role of antiplatelet factor 4 (PF4) antibodies and management strategies based on IV immunoglobulin and nonheparin anticoagulants, which improved outcome. We update current understanding of VITT and potential involvement of anti-PF4 antibodies in thrombotic disorders.
Topics & Concepts
Immune thrombocytopeniaMedicineImmunologyImmune systemPlateletHeparin-Induced Thrombocytopenia and ThrombosisPlatelet Disorders and TreatmentsIntramuscular injections and effects