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Case Reports
. 2024 Mar 1;8(2):102357.
doi: 10.1016/j.rpth.2024.102357. eCollection 2024 Feb.

Thrombocytopenia with and without thrombosis following COVID-19 vaccination: long-term management

M Ge  1 , D Ladha  1 , J Lymer  1 , S Pancic  1   2 , M Carrier  1 , G Le Gal  1 , L A Castellucci  1
Affiliations
Case Reports

Thrombocytopenia with and without thrombosis following COVID-19 vaccination: long-term management

M Ge et al. Res Pract Thromb Haemost. .

Abstract

Background: Since administration of COVID-19 vaccines, there has been growing evidence of thrombotic and thrombocytopenic events following vaccination. However, there remains limited data on long-term management of these adverse hematologic events.

Key clinical question: We report on 9 patients presenting with thrombocytopenia following COVID-19 vaccination, with 4 subsequently diagnosed with vaccine-induced thrombocytopenia and thrombosis (VITT) and 5 with immune thrombocytopenia.

Clinical approach: A retrospective chart review was completed for adults >18 years of age presenting to a tertiary care center with new-onset thrombocytopenia occurring 4 to 42 days following COVID-19 vaccination. Presenting symptoms, laboratory investigations, and response to treatment are described.

Conclusion: Two of 4 patients with VITT developed refractory thrombocytopenia successfully treated with intravenous immunoglobulin, corticosteroids, and plasma exchange therapy. Patients with VITT remained on anticoagulation for at least 9 months due to persistently positive diagnostic tests. Four of 5 patients with immune thrombocytopenia received intravenous immunoglobulin and corticosteroids with good recovery. Patients who received a subsequent COVID-19 mRNA vaccine had no adverse hematologic effects.

Keywords: COVID-19; cohort; thrombocytopenia; thrombosis; vaccination.

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Figures

Figure
Figure
Laboratory trends over time in patients with vaccine-induced thrombocytopenia and thrombosis (VITT) and immune thrombocytopenia (ITP). Inset figures show trends up to 14 days.
Figure
Figure
Laboratory trends over time in patients with vaccine-induced thrombocytopenia and thrombosis (VITT) and immune thrombocytopenia (ITP). Inset figures show trends up to 14 days.
See this image and copyright information in PMC

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