Takatsuki Mari, Araki Toshihiko, Kanno Akira, Yasumoto Atsushi, Morishita Eriko, Shiota Hiroshi
Department of Neurology, Kawaguchi Municipal Medical Center.
Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital.
Rinsho Shinkeigaku. 2022 Jun 24;62(6):487-491. doi: 10.5692/clinicalneurol.cn-001741. Epub 2022 May 28.
A 48-year-old Japanese man who had no previous medical history received his first dose of the ChAdOx1 nCoV-19 vaccine. Ten days after the vaccine administration, he developed a headache. Laboratory results indicated throm-bocytopenia and DIC. A head CT revealed microbleeding in the left parietal lobe. Contrast-enhanced CT showed thrombus in the left transverse sinus and left sigmoid sinus. A brain MRI demonstrated venous hemorrhagic infarction and subarachnoid hemorrhages in the left parietal lobe, and whole-body enhanced CT also revealed portal vein embolism and renal infarction. He was diagnosed with thrombosis with thrombocytopenia syndrome, and was treated according to the guideline. He has been recovering with the treatments. This is the first reported case of TTS associated with the ChAdOx1 nCoV-19 vaccine in Japan.
一名既往无病史的48岁日本男性接种了第一剂ChAdOx1 nCoV-19疫苗。接种疫苗10天后，他出现头痛。实验室检查结果显示血小板减少和弥散性血管内凝血。头部CT显示左侧顶叶有微出血。增强CT显示左侧横窦和左侧乙状窦有血栓形成。脑部MRI显示左侧顶叶有静脉出血性梗死和蛛网膜下腔出血，全身增强CT还显示门静脉栓塞和肾梗死。他被诊断为伴有血小板减少的血栓形成综合征，并按照指南进行治疗。经过治疗，他正在康复。这是日本首例报告的与ChAdOx1 nCoV-19疫苗相关的伴有血小板减少的血栓形成综合征病例。
