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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
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.
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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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