Eltrombopag for refractory vaccine-induced immune thrombotic thrombocytopenia

AbstractVaccine-induced immune thrombotic thrombocytopenia (VITT) is a life-threatening complication described after administration of recombinant adenoviral vector encoding the spike protein antigen of Severe Acute Respiratory Syndrome CoronaVirus-2. The syndrome is characterized by platelet consumption and thrombosis. High levels of antibodies to platelet factor 4 (PF4) –polyanion complexes were identified in many patients with VITT by enzyme-linked immunosorbent assay (ELISA). A 64-year-old woman presented with thrombocytopenia, right renal vein thrombosis with renal infarction, right intra-right atrium and intra-right ventricle thrombosis and pulmonary embolism after ChAdOx1-S vaccine administration. ELISA for antibodies to PF4–polyanion complexes tested positive, while functional tests were not. Thrombocytopenia was refractory to intravenous immunoglobulins and corticosteroids. Eltrombopag was introduced and platelet gradually rose to normal values. VI TT is a novel complication yet to be understood. The clinical case we reported highlights the difficulties in the management of this disorder and discloses a new potential therapy in refractory conditions.
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research

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Conclusions: Compared with historical controls, VTE after adenovirus-based vaccination against SARS-CoV-2 is accompanied by thrombocytopenia, occurs in unusual sites, and is associated with worse clinical outcomes.
Source: Viruses - Category: Virology Authors: Tags: Article Source Type: research
A 68-years-old man presented to the emergency department for left leg swelling with subacute pain, associated with weakness, dizziness and progressive dyspnoea. His medical history included hypertension and an euthyroid nodular goiter; personal history of thrombosis were negative. Molecular test for SARS-Cov2 nucleic acid (PCR) was negative and anti-spike IgG levels were 316 AU/ml. Vaccination for Coronavirus disease 2019 (COVID-19) with a single dose of Janssen Ad26.COV2.S vaccine (Janssen vaccines, Leiden, The Netherlands) was reported 13 days before.
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Case Report Source Type: research
AbstractVaccine-induced immune thrombotic thrombocytopenia (VITT) is a life-threatening complication described after administration of recombinant adenoviral vector encoding the spike protein antigen of Severe Acute Respiratory Syndrome CoronaVirus-2. The syndrome is characterized by platelet consumption and thrombosis. High levels of antibodies to platelet factor 4 (PF4) –polyanion complexes were identified in many patients with VITT by enzyme-linked immunosorbent assay (ELISA). A 64-year-old woman presented with thrombocytopenia, right renal vein thrombosis with renal infarction, right intra-right atrium and intra-...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Hamostaseologie. 2021 Oct;41(5):379-385. doi: 10.1055/a-1581-4355. Epub 2021 Oct 25.ABSTRACTIn 2019 first reports about a new human coronavirus emerged, which causes common cold symptoms as well as acute respiratory distress syndrome. The virus was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and severe thrombotic events including deep vein thrombosis, pulmonary embolism, and microthrombi emerged as additional symptoms. Heart failure, myocardial infarction, myocarditis, and stroke have also been observed. As main mediator of thrombus formation, platelets became one of the key aspects in SARS-C...
Source: Hamostaseologie - Category: Hematology Authors: Source Type: research
NEW BRUNSWICK, N.J., April 23, 2021 – Johnson &Johnson (NYSE: JNJ) (the Company) today announced that vaccinations with the Company’s COVID-19 single-shot vaccine will resume for all adults aged 18 years and older in the U.S., under Emergency Use Authorization (EUA), following a decision from the United States Centers for Disease Control (CDC) and Food and Drug Administration (FDA).The decision was based on a recommendation from the U.S. CDC Advisory Committee on Immunization Practices (ACIP), which followed a rigorous evaluation of data relating to a very rare adverse event involving blood clots in combina...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Our Company Source Type: news
AbstractLatin America (LATAM) children offer special insight into Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV2) due to high-risk race/ethnicity, variability in medical resources, diverse socioeconomic background, and numerous involved organ systems. This multinational study of LATAM youth examined the distinguishing features of acute or late multisystem SARS COV2 with versus without cardiac involvement. A consecutive sample of youth 0 –18 years old (N = 98;50% male) presenting with multisystem SARS COV2 to 32 centers in 10 Latin American countries participating in a pediatric cardiac multi-imaging socie...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
In conclusion, a complex interaction of SARS-CoV-2 virus invasion with platelets, leukocytes, endothelial cells, inflammation, immune response, and the possible involvement of megakaryocytes may increase the cumulative risk of thrombosis by a yet unclear cellular and humoral interaction.PMID:33629337 | DOI:10.26355/eurrev_202102_24878
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Authors: Source Type: research
AbstractCoronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its e...
Source: Annals of Hematology - Category: Hematology Source Type: research
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