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Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series
During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was the rapid and severe progression of disease in spite of maximum treatment efforts, resulting in fatal out...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363077/ https://www.ncbi.nlm.nih.gov/pubmed/34393988 http://dx.doi.org/10.3389/fneur.2021.721146 |
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author | Wiedmann, Markus Skattør, Thor Stray-Pedersen, Arne Romundstad, Luis Antal, Ellen-Ann Marthinsen, Pål Bache Sørvoll, Ingvild Hausberg Leiknes Ernstsen, Siw Lund, Christian G. Holme, Pål Andre Johansen, Tonje Okkenhaug Brunborg, Cathrine Aamodt, Anne Hege Schultz, Nina Haagenrud Skagen, Karolina Skjelland, Mona |
author_facet | Wiedmann, Markus Skattør, Thor Stray-Pedersen, Arne Romundstad, Luis Antal, Ellen-Ann Marthinsen, Pål Bache Sørvoll, Ingvild Hausberg Leiknes Ernstsen, Siw Lund, Christian G. Holme, Pål Andre Johansen, Tonje Okkenhaug Brunborg, Cathrine Aamodt, Anne Hege Schultz, Nina Haagenrud Skagen, Karolina Skjelland, Mona |
author_sort | Wiedmann, Markus |
collection | PubMed |
description | During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was the rapid and severe progression of disease in spite of maximum treatment efforts, resulting in fatal outcome in for 4 out of 5 patients. All cases had received ChAdOx1 nCov-19 vaccine 1–2 weeks earlier and developed a characteristic syndrome thereafter. The rapid progressive clinical course and high fatality rate of CVT in combination with thrombocytopenia in such a cluster and in otherwise healthy adults is a recent phenomenon. Cerebral autopsy findings were those of venous hemorrhagic infarctions and thrombi in dural venous sinuses, including thrombus material apparently rich in thrombocytes, leukocytes and fibrin. Vessel walls were free of inflammation. Extra-cerebral manifestations included leech-like thrombi in large veins, fibrin clots in small venules and scattered hemorrhages on skin and membranes. CVT with thrombocytopenia after adenovirus vectored COVID-19 vaccination is a new clinical syndrome that needs to be recognized by clinicians, is challenging to treat and seems associated with a high mortality rate. |
format | Online Article Text |
id | pubmed-8363077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83630772021-08-14 Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series Wiedmann, Markus Skattør, Thor Stray-Pedersen, Arne Romundstad, Luis Antal, Ellen-Ann Marthinsen, Pål Bache Sørvoll, Ingvild Hausberg Leiknes Ernstsen, Siw Lund, Christian G. Holme, Pål Andre Johansen, Tonje Okkenhaug Brunborg, Cathrine Aamodt, Anne Hege Schultz, Nina Haagenrud Skagen, Karolina Skjelland, Mona Front Neurol Neurology During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was the rapid and severe progression of disease in spite of maximum treatment efforts, resulting in fatal outcome in for 4 out of 5 patients. All cases had received ChAdOx1 nCov-19 vaccine 1–2 weeks earlier and developed a characteristic syndrome thereafter. The rapid progressive clinical course and high fatality rate of CVT in combination with thrombocytopenia in such a cluster and in otherwise healthy adults is a recent phenomenon. Cerebral autopsy findings were those of venous hemorrhagic infarctions and thrombi in dural venous sinuses, including thrombus material apparently rich in thrombocytes, leukocytes and fibrin. Vessel walls were free of inflammation. Extra-cerebral manifestations included leech-like thrombi in large veins, fibrin clots in small venules and scattered hemorrhages on skin and membranes. CVT with thrombocytopenia after adenovirus vectored COVID-19 vaccination is a new clinical syndrome that needs to be recognized by clinicians, is challenging to treat and seems associated with a high mortality rate. Frontiers Media S.A. 2021-07-30 /pmc/articles/PMC8363077/ /pubmed/34393988 http://dx.doi.org/10.3389/fneur.2021.721146 Text en Copyright © 2021 Wiedmann, Skattør, Stray-Pedersen, Romundstad, Antal, Marthinsen, Sørvoll, Leiknes Ernstsen, Lund, Holme, Johansen, Brunborg, Aamodt, Schultz, Skagen and Skjelland. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Wiedmann, Markus Skattør, Thor Stray-Pedersen, Arne Romundstad, Luis Antal, Ellen-Ann Marthinsen, Pål Bache Sørvoll, Ingvild Hausberg Leiknes Ernstsen, Siw Lund, Christian G. Holme, Pål Andre Johansen, Tonje Okkenhaug Brunborg, Cathrine Aamodt, Anne Hege Schultz, Nina Haagenrud Skagen, Karolina Skjelland, Mona Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title | Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title_full | Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title_fullStr | Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title_full_unstemmed | Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title_short | Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series |
title_sort | vaccine induced immune thrombotic thrombocytopenia causing a severe form of cerebral venous thrombosis with high fatality rate: a case series |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8363077/ https://www.ncbi.nlm.nih.gov/pubmed/34393988 http://dx.doi.org/10.3389/fneur.2021.721146 |
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