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Case Reports
. 2021 Jul;19(7):1819-1822.
doi: 10.1111/jth.15346. Epub 2021 Jun 11.

Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT)

Johannes Thaler  1 , Cihan Ay  1 , Karoline V Gleixner  1 , Alexander W Hauswirth  1 , Filippo Cacioppo  2 , Jürgen Grafeneder  2 , Peter Quehenberger  3 , Ingrid Pabinger  1 , Paul Knöbl  1
Affiliations
Case Reports

Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT)

Johannes Thaler et al. J Thromb Haemost. 2021 Jul.

Abstract

Cases of unusual thrombosis and thrombocytopenia after administration of the ChAdOx1 nCoV-19 vaccine (AstraZeneca) have been reported. The term vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) was coined to reflect this new phenomenon. In vitro experiments with VIPIT patient sera indicated that high-dose intravenous immunoglobulins (IVIG) competitively inhibit the platelet-activating properties of ChAdOx1 nCoV-19 vaccine induced antibodies. Here, we report a case of a 62-year-old woman who had received this vaccine and developed VIPIT. She visited the emergency ward because of petechiae and hematomas. In the laboratory work-up, thrombocytopenia, low fibrinogen, elevated D-dimer, and positivity in the platelet factor 4/heparin-enzyme-immunoassay were present. Signs and symptoms of thrombosis were absent. Upon immediate therapy with non-heparin anticoagulation, high-dose IVIG, and prednisolone, laboratory parameters steadily improved and the patient was discharged from hospital without thrombotic complications. We conclude that early initiation of VIPIT treatment results in a swift response without thrombotic complications.

Keywords: COVID-19; ChAdOx1 vaccine; VIPIT; high-dose intravenous immunoglobulins; vaccine-induced prothrombotic immune thrombocytopenia.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Time course of platelet count (red), fibrinogen concentration (yellow), and D‐dimer (blue) during treatment of vaccine‐induced prothrombotic immune thrombocytopenia
See this image and copyright information in PMC

Comment in

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