Samuel Bersinger1, Kevin Lagarde, Raphael Marlu, Gilles Pernod, Jean-Francois Payen. 1. Department of Anesthesia and Critical Care, University of Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France. Department of Biology, Hemostasis Unit, University of Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France. Department of Vascular Medicine, University of Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France.
Abstract
OBJECTIVES: To describe the successful recovery from multiple and life-threatening venous thrombosis after ChAdOx1 nCoV-19 vaccination. DESIGN: Case report. SETTING: University Hospital. PATIENT: Few days after the first dose of the ChAdOx1 nCoV-19 vaccine, a 21-year-old woman experienced massive thrombosis in the deep and superficial cerebral veins together with seizures, neurologic focal deficit, and thrombocytopenia. In the neurointensive care unit, her condition worsened despite early decompressive craniectomy. She developed bilateral segmental pulmonary embolism, left hepatic, and left external iliac venous thrombosis. INTERVENTION: Argatroban (0.5-2.2 µg/kg/min) and high-dose IV immunoglobulin (1 g/kg/d for 2 consecutive days) were initiated on day 6 after admission. With these therapies, there was a gradual resolution of multiple sites of venous thrombosis, and platelet count returned to normal. The patient left the ICU with full consciousness, expressive aphasia, and right hemiparesis. CONCLUSIONS: This case of vaccine-induced immune thrombotic thrombocytopenia shows that a good outcome can be obtained even with multiple and life-threatening venous thrombotic lesions. Argatroban and high-dose IV immunoglobulin along with management of severe cerebral venous thrombosis played a major role in this epilogue.
OBJECTIVES: To describe the successful recovery from multiple and life-threatening venous thrombosis after ChAdOx1 nCoV-19 vaccination. DESIGN: Case report. SETTING: University Hospital. PATIENT: Few days after the first dose of the ChAdOx1 nCoV-19 vaccine, a 21-year-old woman experienced massive thrombosis in the deep and superficial cerebral veins together with seizures, neurologic focal deficit, and thrombocytopenia. In the neurointensive care unit, her condition worsened despite early decompressive craniectomy. She developed bilateral segmental pulmonary embolism, left hepatic, and left external iliac venous thrombosis. INTERVENTION: Argatroban (0.5-2.2 µg/kg/min) and high-dose IV immunoglobulin (1 g/kg/d for 2 consecutive days) were initiated on day 6 after admission. With these therapies, there was a gradual resolution of multiple sites of venous thrombosis, and platelet count returned to normal. The patient left the ICU with full consciousness, expressive aphasia, and right hemiparesis. CONCLUSIONS: This case of vaccine-induced immune thrombotic thrombocytopenia shows that a good outcome can be obtained even with multiple and life-threatening venous thrombotic lesions. Argatroban and high-dose IV immunoglobulin along with management of severe cerebral venous thrombosis played a major role in this epilogue.
Authors: Rave Harpaz; William DuMouchel; Robbert Van Manen; Alexander Nip; Steve Bright; Ana Szarfman; Joseph Tonning; Magnus Lerch Journal: Drug Saf Date: 2022-06-23 Impact factor: 5.228
Authors: Saad Alhumaid; Abbas Al Mutair; Ali A Rabaan; Fatemah M ALShakhs; Om Prakash Choudhary; Shin Jie Yong; Firzan Nainu; Amjad Khan; Javed Muhammad; Fadil Alhelal; Mohammed Hussain Al Khamees; Hussain Ahmed Alsouaib; Ahmed Salman Al Majhad; Hassan Redha Al-Tarfi; Ali Hussain ALyasin; Yaqoub Yousef Alatiyyah; Ali Ahmed Alsultan; Mohammed Essa Alessa; Mustafa Essa Alessa; Mohammed Ahmed Alissa; Emad Hassan Alsayegh; Hassan N Alshakhs; Haidar Abdullah Al Samaeel; Rugayah Ahmed AlShayeb; Dalal Ahmed Alnami; Hussain Ali Alhassan; Abdulaziz Abdullah Alabdullah; Ayat Hussain Alhmed; Faisal Hussain AlDera; Khalid Hajissa; Jaffar A Al-Tawfiq; Awad Al-Omari Journal: BMC Gastroenterol Date: 2022-10-13 Impact factor: 2.847