Page David, Zhu Nancy, Sawler Daniel, Sun Hao Wei, Turley Elona, Pai Menaka, Wu Cynthia
Division of Hematology Department of Medicine University of Alberta Edmonton AB Canada.
Department of Laboratory Medicine & Pathology University of Alberta Edmonton AB Canada.
Res Pract Thromb Haemost. 2021 Sep 14;5(6):e12596. doi: 10.1002/rth2.12596. eCollection 2021 Aug.
Adenoviral-vector based vaccines for coronavirus disease 2019 (COVID-19) have been linked with a thrombotic syndrome, vaccine-induced thrombotic thrombocytopenia (VITT). A key clinical question is whether VITT can be reliably ruled out by the absence of thrombocytopenia. We report on three patients who presented to our institute with this syndrome. Noteworthy in our presentations are two patients who presented for medical assessment of thrombotic symptoms with a normal platelet count, one preceding and one following a period of thrombocytopenia. Prompt diagnosis of VITT is critical to prevent rapid patient decline. We provide herein a new diagnostic algorithm that we believe will help optimally capture case presentations of VITT. These cases broaden and refine our understanding of the disease process and highlight to practitioners that VITT cannot be adequately ruled out by thrombocytopenia alone.
基于腺病毒载体的2019冠状病毒病（COVID-19）疫苗与一种血栓形成综合征——疫苗诱导的血栓性血小板减少症（VITT）有关。一个关键的临床问题是，血小板减少症的缺失能否可靠地排除VITT。我们报告了三例患有这种综合征并前来我院就诊的患者。在我们的病例介绍中值得注意的是，有两名患者因血栓形成症状前来进行医学评估，其血小板计数正常，其中一名在血小板减少症出现之前，另一名在血小板减少症出现之后。VITT的及时诊断对于防止患者病情迅速恶化至关重要。我们在此提供一种新的诊断算法，我们相信它将有助于最佳地捕捉VITT的病例表现。这些病例拓宽并完善了我们对疾病过程的理解，并向从业者强调，不能仅通过血小板减少症就充分排除VITT。
