Schultz Nina H, Sørvoll Ingvild H, Michelsen Annika E, Munthe Ludvig A, Lund-Johansen Fridtjof, Ahlen Maria T, Wiedmann Markus, Aamodt Anne-Hege, Skattør Thor H, Tjønnfjord Geir E, Holme Pål A
From the Departments of Hematology (N.H.S., G.E.T., P.A.H.), Immunology (L.A.M., F.L.-J.), Neurosurgery (M.W.), Neurology (A.-H.A.), and Radiology and Nuclear Medicine (T.H.S.), and the Research Institute of Internal Medicine (N.H.S., A.E.M., P.A.H.), Oslo University Hospital, and the Faculty of Medicine (A.E.M., G.E.T., P.A.H.), the KG Jebsen Center for B Cell Malignancy (L.A.M., G.E.T.), Institute of Clinical Medicine, and the ImmunoLingo Convergence Center (F.L.-J.), University of Oslo, the Department of Hematology, Akershus University Hospital, Lørenskog (N.H.S.), and the Norwegian National Unit for Platelet Immunology, Division of Diagnostics, University Hospital of North Norway, Tromsø (I.H.S., M.T.A.) - all in Norway.
N Engl J Med. 2021 Jun 3;384(22):2124-2130. doi: 10.1056/NEJMoa2104882. Epub 2021 Apr 9.
We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The patients were health care workers who were 32 to 54 years of age. All the patients had high levels of antibodies to platelet factor 4-polyanion complexes; however, they had had no previous exposure to heparin. Because the five cases occurred in a population of more than 130,000 vaccinated persons, we propose that they represent a rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia that we refer to as vaccine-induced immune thrombotic thrombocytopenia.
我们报告了5例患者的情况，这些患者在接种第一剂ChAdOx1 nCoV-19腺病毒载体新冠疫苗（用于预防2019冠状病毒病，即Covid-19）后7至10天出现静脉血栓形成和血小板减少。这些患者均为年龄在32至54岁的医护人员。所有患者针对血小板因子4-多聚阴离子复合物的抗体水平均较高；然而，他们之前均未接触过肝素。由于这5例病例出现在超过13万名接种疫苗的人群中，我们认为它们代表了一种罕见的与疫苗相关的自发性肝素诱导的血小板减少变异型，我们将其称为疫苗诱导的免疫性血栓性血小板减少症。
