Vaccine-induced immune thrombotic thrombocytopenia following AstraZeneca (ChAdOx1 nCoV-19) vaccine: report of two cases


Submitted: 1 March 2022
Accepted: 6 May 2022
Published: 23 May 2022
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Authors

  • Rita Carlotta Santoro Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Roberto Minici Diagnostic Radiology Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Marzia Leotta Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Mariapia Falbo Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Lucia Concetta Elia Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Francesca Leo Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Antonella Ierardi Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Alessandra Strangio Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
  • Simona Prejanò Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.

Vaccination with ChAdOx1 nCoV-19 can result in vaccine-induced immune thrombotic thrombocytopenia (VITT). This phenomenon mimics heparin-induced thrombocytopenia, yet it does not require heparin as a trigger. This case report highlights the potentially lifethreatening complication associated with ChAdOx1 nCov-19 vaccine, clinical presentation, diagnostic approach, and treatment. We report two cases of vaccine-induced immune thrombotic thrombocytopenia after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute these thrombotic conditions to the vaccine due to the remarkable temporal relationship. The proposed mechanism of VITT is a production of antibodies against platelet factor-4 resulting in massive platelet activation. Healthcare providers should be aware of the possibility of such a fatal complication, and the vaccine recipients should be warned about the symptoms of VITT.


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Marzia Leotta, Hemostasis and Thrombosis Center Unit, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro

 

 

Santoro, R. C., Minici, R., Leotta, M., Falbo, M., Elia, L. C., Leo, F., Ierardi, A. ., Strangio, A., & Prejanò, S. (2022). Vaccine-induced immune thrombotic thrombocytopenia following AstraZeneca (ChAdOx1 nCoV-19) vaccine: report of two cases. Bleeding, Thrombosis, and Vascular Biology, 1(2). https://doi.org/10.4081/btvb.2022.23

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