Dear Editor, we would like to share ideas on the publication “Vaccine induced thrombotic thrombocytopenia: The shady chapter of a success story [1].” Tsilingiris al. noted that “besides, with the issue of the potential necessity of additional boosters or even of repeat vaccinations on an annual basis still remaining open, further reasons for debate on the subject of VITT/TTS management are bound to emerge. [1].” We agree that vaccine induced thrombotic thrombocytopenia is a possible adverse reaction to COVID-19 vaccine. Tsilingiris et al. mentioned for several possible underlying mechanism of the problem including autoantibodies, megacaryocytes entry, direct platelet and endothelial cell binding/activation, activation of endothelial and inflammatory cells, inflammatory co-signal and circulating soluble spike protein variants following vaccination [1]. However, there are still other mechanisms that should be noted. First, the molecular mimicry phenomenon might exist and the cross-antibody reaction might be the cause of the problem [2]. Second, the thrombocytopenia might also be associated with increased blood viscosity after vaccination [3,4]. Finally, we should recognize of chance of other coincidence. For example, a dengue coinfection might be possible and can cause thrombocytopenia problem [5].
Authors contributions
RM 50% - 1a Substantial contributions to study conception and design 1b. Substantial contributions to acquisition of data 1c. Substantial contributions to analysis and interpretation of data 2. Drafting the article or revising it critically for important intellectual content 3. Final approval of the version of the article to be published.VW 50% - 1a Substantial contributions to study conception and design 1b. Substantial contributions to acquisition of data 1c. Substantial contributions to analysis and interpretation of data 2. Drafting the article or revising it critically for important intellectual content 3. Final approval of the version of the article to be published.