Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector-based COVID-19 vaccine

被引：103

作者：

Blauenfeldt, Rolf Ankerlund ^{[1
,2
]}

Kristensen, Soren Risom ^{[3
,4
]}

Ernstsen, Siw Leiknes ^{[5
]}

Kristensen, Claudia Christina Hilt ^{[1
,4
]}

Simonsen, Claus Ziegler ^{[2
,6
,7
]}

Hvas, Anne-Mette ^{[8
]}

机构：

[1] Aalborg Univ Hosp, Dept Neurol, DK-9000 Aalborg, Denmark

[2] Aarhus Univ, Dept Clin Med, Aarhus, Denmark

[3] Aalborg Univ Hosp, Dept Clin Biochem, Aalborg, Denmark

[4] Aalborg Univ, Dept Clin Med, Aalborg, Denmark

[5] Univ Hosp North Norway, Norwegian Natl Unit Platelet Immunol, Tromso, Norway

[6] Aarhus Univ Hosp, Dept Neurol, Aarhus, Denmark

[7] Aarhus Univ Hosp, Danish Stroke Ctr, Aarhus, Denmark

[8] Aarhus Univ Hosp, Dept Clin Biochem, Aarhus, Denmark

来源：

JOURNAL OF THROMBOSIS AND HAEMOSTASIS | 2021年 / 19卷 / 07期

基金：

美国国家卫生研究院;

关键词：

hemorrhage; platelet factor; stroke; thrombocytopenia; vaccines;

D O I：

10.1111/jth.15347

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We describe the first Danish case of presumed inflammatory and thrombotic response to vaccination with an adenoviral (ChAdOx1) vector-based COVID-19 vaccine (AZD1222). The case describes a 60-year-old woman who was admitted with intractable abdominal pain 7 days after receiving the vaccine. Computed tomography of the abdomen revealed bilateral adrenal hemorrhages. On the following day, she developed a massive right-sided ischemic stroke and magnetic resonance imaging angiography showed occlusion of the right internal carotid artery. The ischemic area was deemed too large to offer reperfusion therapy. During admission, blood tests showed a remarkable drop in platelet counts from 118,000 to 5000 per mu l and a substantial increase in D-dimer. The patient died on the sixth day of hospitalization. Blood tests revealed platelet factor 4 reactive antibodies, imitating what is seen in heparin-induced thrombocytopenia. This may be a novel immune-mediated response to the vaccine.

引用

页码：1771 / 1775

页数：5

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