Al-Ahmad Mona, Al Rasheed Mona, Altourah Lulwa, Rodriguez-Bouza Tito, Shalaby Neveen
Microbiology Department, Faculty of Medicine, Kuwait University.
Al Rashed Allergy Centre, Ministry of Health.
Blood Coagul Fibrinolysis. 2023 Jan 1;34(1):75-78. doi: 10.1097/MBC.0000000000001161. Epub 2022 Aug 9.
Some reports have discussed the development of a new entity called vaccine-induced immune thrombotic thrombocytopenia after COVID-19 vaccination. In this case series, we are describing four patients who have developed lupus anticoagulant-associated venous thromboembolism after Pfizer mRNA COVID-19 vaccination. All were COVID-19 negative on admission. Three had developed thrombosis after the first dose and one after the second dose of vaccination. All of them had venous thrombosis. Three patients developed thrombosis 2 weeks after vaccination and the fourth patient had developed thrombosis after 3 weeks of vaccination. None of the patients had thrombocytopenia on or during admission as seen in the case of vaccine-induced immune thrombotic thrombocytopenia. All patients had positive lupus anticoagulant and negative anticardiolipin antibodies and antibeta2 glycoprotein I. All of them were stable on discharge and were treated with low molecular weight heparin followed by warfarin. We suggest the presence of a possible link between the development of antiphospholipid antibodies and COVID-19 vaccine that requires further assessment.
一些报告讨论了一种新病症的出现，即新冠疫苗接种后疫苗诱导的免疫性血栓性血小板减少症。在本病例系列中，我们描述了四名在接种辉瑞新冠mRNA疫苗后发生狼疮抗凝物相关静脉血栓栓塞的患者。所有患者入院时新冠病毒检测均为阴性。三名患者在接种第一剂疫苗后发生血栓形成，一名患者在接种第二剂疫苗后发生血栓形成。他们均发生了静脉血栓形成。三名患者在接种疫苗后2周出现血栓形成，第四名患者在接种疫苗3周后出现血栓形成。与疫苗诱导的免疫性血栓性血小板减少症病例不同，所有患者在入院时或住院期间均未出现血小板减少症。所有患者狼疮抗凝物呈阳性，抗心磷脂抗体和抗β2糖蛋白I呈阴性。所有患者出院时情况稳定，接受了低分子量肝素治疗，随后使用华法林。我们认为抗磷脂抗体的产生与新冠疫苗之间可能存在联系，这需要进一步评估。
