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Case Reports
. 2021 Aug 26;385(9):857-859.
doi: 10.1056/NEJMc2109465. Epub 2021 Jul 7.

Therapeutic Plasma Exchange in Vaccine-Induced Immune Thrombotic Thrombocytopenia

Christopher J Patriquin  1 , Vincent Laroche  2 , Rita Selby  3 , Jacob Pendergrast  3 , David Barth  3 , Benoit Côté  2 , Nathalie Gagnon  2 , Guillaume Roberge  2 , Marc Carrier  4 , Lana A Castellucci  4 , Dimitrios Scarvelis  4 , Johnathan P Mack  4
Affiliations
Case Reports

Therapeutic Plasma Exchange in Vaccine-Induced Immune Thrombotic Thrombocytopenia

Christopher J Patriquin et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Clinical Course in Patients with Refractory VITT Treated with Therapeutic Plasma Exchange.
For all three patients, day 1 of the hospital stay was also the day on which suspected or confirmed VITT was diagnosed. Standard doses of anticoagulant were given to all three patients. Prednisone was given at a dose of 1 mg per kilogram of body weight. In each patient, the initial d-dimer level was above the upper limit of quantification of the assay used in the hospital to which she had been admitted; on day 2, Patient 3 was transferred to a hospital in which the laboratory used an assay with a higher upper limit of quantification. The d-dimer values have been converted to micrograms per liter fibrinogen equivalent units (FEU) for case comparison. The colors of the symbols below the x axis in each panel (indicating types of medical imaging performed) denote stable disease or improvement (black) or disease progression (red) relative to previous scans. Light blue shading indicates the normal range for platelet count. Details of the serial imaging are provided in the Supplementary Appendix. CT denotes computed tomography, ELISA enzyme-linked immunosorbent assay, IVIG intravenous immune globulin, MP methylprednisolone, MRI magnetic resonance imaging, OD optical density, SRA serotonin release assay, and TPE therapeutic plasma exchange.
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References

    1. Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med 2021;384:2092-2101. - PMC - PubMed
    1. Schultz NH, Sørvoll IH, Michelsen AE, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med 2021;384:2124-2130. - PMC - PubMed
    1. Scully M, Singh D, Lown R, et al. Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med 2021;384:2202-2211. - PMC - PubMed
    1. Jones CG, Pechauer SM, Curtis BR, Bougie DW, Aster RH, Padmanabhan A. Normal plasma IgG inhibits HIT antibody-mediated platelet activation: implications for therapeutic plasma exchange. Blood 2018;131:703-706. - PMC - PubMed
    1. Pavord S, Lester W, Makris M, Scully M, Hunt B. Guidance from the Expert Haematology Panel (EHP) on Covid-19 vaccine-induced immune thrombocytopenia and thrombosis (VITT). London: British Society for Haematology, May 28, 2021. - PMC - PubMed

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