Mauriello Alessandro, Scimeca Manuel, Amelio Ivano, Massoud Renato, Novelli Antonio, Di Lorenzo Francesca, Finocchiaro Susanna, Cimino Carolina, Telesca Rossana, Chiocchi Marcello, Sun Qiang, Wang Ying, Shi Yufang, Novelli Giuseppe, Melino Gerry
Department of Experimental Medicine, TOR, University of Rome Tor Vergata, 00133, Rome, Italy.
School of Life Sciences, University of Nottingham, Nottingham, UK.
Cell Death Dis. 2021 Aug 3;12(8):762. doi: 10.1038/s41419-021-04058-z.
While vaccination is the single most effective intervention to drastically reduce severe disease and death following SARS-CoV-2 infection, as shown in UK and Israel, some serious concerns have been raised for an unusual adverse drug reaction (ADR), including vaccine-induced immune thrombotic thrombocytopenia (VITT) with concurrent low platelets as well as capillary leak syndrome. In fact, the overall safety of the vaccine is highlighted by the low frequency of ADR considering that in UK, by the early June, 40 million first doses and 29 million second doses have been injected; nonetheless, 390 thrombotic events, including 71 fatal events have been reported. Interestingly, the cases reported low platelet counts with the presence of anti-platelet factor-4 (PF4) antibodies, indicating an abnormal clotting reaction. Here, out of three referred cases, we report a post-vaccine clinical case of fatal thrombosis with postmortem examination and whole exome sequencing (WES) analysis, whose pathogenesis appeared associated to a preexisting condition of thrombocytopenia due to myelodysplasia.
虽然如英国和以色列所示，接种疫苗是大幅降低感染新冠病毒后严重疾病和死亡的最有效干预措施，但人们对一种不寻常的药物不良反应（ADR）提出了一些严重担忧，包括疫苗诱导的免疫性血栓性血小板减少症（VITT）并伴有血小板减少以及毛细血管渗漏综合征。事实上，考虑到在英国，截至6月初已注射了4000万剂第一剂和2900万剂第二剂，而ADR的低发生率凸显了疫苗的总体安全性；尽管如此，仍报告了390例血栓形成事件，包括71例致命事件。有趣的是，这些病例报告血小板计数低且存在抗血小板因子4（PF4）抗体，表明存在异常凝血反应。在此，在三例转诊病例中，我们报告了一例接种疫苗后的致命血栓形成临床病例，并进行了尸检和全外显子测序（WES）分析，其发病机制似乎与骨髓发育异常导致的血小板减少症的既往病史有关。
