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Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea

Vaccination with an adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in the rare development of thrombosis with thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4). This is a life-threating condition tha...

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Autores principales: Choi, Jae-Ki, Kim, Sunghan, Kim, Seo Ree, Jin, Jong-Youl, Choi, Seon Woong, Kim, Hoon, Yoo, Jin-Hong, Park, Ik Seong, Kim, Seong-Rim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352786/
https://www.ncbi.nlm.nih.gov/pubmed/34402235
http://dx.doi.org/10.3346/jkms.2021.36.e223
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author Choi, Jae-Ki
Kim, Sunghan
Kim, Seo Ree
Jin, Jong-Youl
Choi, Seon Woong
Kim, Hoon
Yoo, Jin-Hong
Park, Ik Seong
Kim, Seong-Rim
author_facet Choi, Jae-Ki
Kim, Sunghan
Kim, Seo Ree
Jin, Jong-Youl
Choi, Seon Woong
Kim, Hoon
Yoo, Jin-Hong
Park, Ik Seong
Kim, Seong-Rim
author_sort Choi, Jae-Ki
collection PubMed
description Vaccination with an adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in the rare development of thrombosis with thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4). This is a life-threating condition that may be accompanied by bleeding due to thrombocytopenia with thrombosis of the cerebral venous sinus or splanchnic vein. Herein, we describe the first fatal case of thrombosis with thrombocytopenia syndrome in Korea, presenting with intracranial hemorrhage caused by cerebral venous sinus thrombosis. A 33-year-old Korean man received the first dose of the ChAdOx1 nCoV-19 vaccination. He developed severe headache with vomiting 9 days after the vaccination. Twelve days after vaccination, he was admitted to the hospital with neurological symptoms and was diagnosed with cerebral venous sinus thrombosis, which was accompanied by intracranial hemorrhage. Thrombocytopenia and D-dimer elevation were observed, and the result of the PF4 enzyme-linked immunosorbent assay antibody test was reported to be strongly positive. Despite intensive treatment, including intravenous immunoglobulin injection and endovascular mechanical thrombectomy, the patient died 19 days after vaccination. Physicians need to be aware of thrombosis with thrombocytopenia syndrome (TTS) in adenoviral vector-vaccinated patients. Endovascular mechanical thrombectomy might be a useful therapeutic option for the treatment of TTS with cerebral venous sinus thrombosis.
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spelling pubmed-83527862021-08-12 Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea Choi, Jae-Ki Kim, Sunghan Kim, Seo Ree Jin, Jong-Youl Choi, Seon Woong Kim, Hoon Yoo, Jin-Hong Park, Ik Seong Kim, Seong-Rim J Korean Med Sci Case Report Vaccination with an adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in the rare development of thrombosis with thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4). This is a life-threating condition that may be accompanied by bleeding due to thrombocytopenia with thrombosis of the cerebral venous sinus or splanchnic vein. Herein, we describe the first fatal case of thrombosis with thrombocytopenia syndrome in Korea, presenting with intracranial hemorrhage caused by cerebral venous sinus thrombosis. A 33-year-old Korean man received the first dose of the ChAdOx1 nCoV-19 vaccination. He developed severe headache with vomiting 9 days after the vaccination. Twelve days after vaccination, he was admitted to the hospital with neurological symptoms and was diagnosed with cerebral venous sinus thrombosis, which was accompanied by intracranial hemorrhage. Thrombocytopenia and D-dimer elevation were observed, and the result of the PF4 enzyme-linked immunosorbent assay antibody test was reported to be strongly positive. Despite intensive treatment, including intravenous immunoglobulin injection and endovascular mechanical thrombectomy, the patient died 19 days after vaccination. Physicians need to be aware of thrombosis with thrombocytopenia syndrome (TTS) in adenoviral vector-vaccinated patients. Endovascular mechanical thrombectomy might be a useful therapeutic option for the treatment of TTS with cerebral venous sinus thrombosis. The Korean Academy of Medical Sciences 2021-08-02 /pmc/articles/PMC8352786/ /pubmed/34402235 http://dx.doi.org/10.3346/jkms.2021.36.e223 Text en © 2021 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Choi, Jae-Ki
Kim, Sunghan
Kim, Seo Ree
Jin, Jong-Youl
Choi, Seon Woong
Kim, Hoon
Yoo, Jin-Hong
Park, Ik Seong
Kim, Seong-Rim
Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title_full Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title_fullStr Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title_full_unstemmed Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title_short Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
title_sort intracerebral hemorrhage due to thrombosis with thrombocytopenia syndrome after vaccination against covid-19: the first fatal case in korea
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352786/
https://www.ncbi.nlm.nih.gov/pubmed/34402235
http://dx.doi.org/10.3346/jkms.2021.36.e223
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