阿斯利康新冠疫苗接种后发生的脑出血和血小板减少症：疫苗诱导的血栓性血小板减少症的临床和诊断挑战
Intracerebral Hemorrhage and Thrombocytopenia After AstraZeneca COVID-19 Vaccine: Clinical and Diagnostic Challenges of Vaccine-Induced Thrombotic Thrombocytopenia.
作者信息
Wilting Floor N H, Kotsopoulos Angela M M, Platteel Anouk C M, van Oers Jos A H
机构信息
Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, NLD.
Department of Intensive Care Medicine, Elisabeth-TweeSteden Hospital, Tilburg, NLD.
出版信息
Cureus. 2021 Sep 1;13(9):e17637. doi: 10.7759/cureus.17637. eCollection 2021 Sep.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a prothrombotic disorder, which has been described as a rare adverse effect of the adenoviral-vectored coronavirus disease 2019 (COVID-19) vaccines. The diagnosis is confirmed by the detection of anti-platelet factor 4 (PF4) antibodies by enzyme-linked immunosorbent assay (ELISA) or functional assay in individuals with the appropriate clinical history. Here, we report a case of a patient who presented with a severe intracerebral hemorrhage and thrombocytopenia 14 days after receiving the first dose of the Oxford-AstraZeneca COVID-19 vaccine, with negative PF4/heparin antibodies tested with ELISA, but positive heparin-induced platelet activation assay (HIPAA).
疫苗诱导的免疫性血栓性血小板减少症（VITT）是一种血栓前状态疾病，已被描述为2019冠状病毒病（COVID-19）腺病毒载体疫苗的一种罕见不良反应。对于有相应临床病史的个体，通过酶联免疫吸附测定（ELISA）或功能测定检测抗血小板因子4（PF4）抗体来确诊。在此，我们报告一例患者，在接种第一剂牛津-阿斯利康COVID-19疫苗14天后出现严重脑出血和血小板减少症，ELISA检测PF4/肝素抗体为阴性，但肝素诱导的血小板活化测定（HIPAA）为阳性。
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