RT Journal Article
SR Electronic
T1 Arterial and venous thrombotic stroke after ChAdOx1 nCoV-19 vaccine
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 184
OP 186
DO 10.7861/clinmed.2021-0321
VO 22
IS 2
A1 Adrian Wills
A1 Gillian Swallow
A1 Matthew A Kirkman
A1 Krishna Rajan
A1 Ganesh Subramanian
YR 2022
UL http://www.rcpjournals.org/content/22/2/184.abstract
AB Vaccine-induced thrombosis with thrombocytopenia (VITT) is a recently-described condition associated with arterial and venous thrombosis following vaccination with the ChAdOx1 nCoV-19 (AstraZeneca) vaccine. This report describes two cases of stroke caused by arterial and venous thromboses presenting within 28 days of receiving the AstraZeneca vaccine. The patients were otherwise young and healthy with minimal risk factors for thrombosis yet developed a rapid, ultimately fatal neurological deterioration.The patients were significantly thrombocytopenic with disproportionately raised D-dimers, both of which are widely reported in this condition. Both cases had measurable immunoglobulin G platelet factor-4 antibodies detected via enzyme-linked immunosorbent assay, similar to those described in heparin-induced thrombocytopenia.These cases illustrate that physicians should be especially mindful of VITT in the context of evolving evidence on treatment and in view of the potentially rapid and catastrophic neurological deterioration, leading to fatality despite best supportive care.