Departments of Pathology and Laboratory Medicine and Medicine, Perelman-University of Pennsylvania School of Medicine, Philadelphia, PA.
Institut für Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany.
Blood. 2023 Apr 6;141(14):1659-1665. doi: 10.1182/blood.2022017696.
Within the first months of the COVID-19 vaccination campaign, previously healthy recipients who developed severe thrombosis (often cerebral and/or splanchnic vasculature) and thrombocytopenia typically after adenoviral vector-based vaccination were identified. Similarities between this syndrome, vaccine-induced immune thrombotic thrombocytopenia (VITT), and heparin-induced thrombocytopenia prompted recognition of the role of antiplatelet factor 4 (PF4) antibodies and management strategies based on IV immunoglobulin and nonheparin anticoagulants, which improved outcome. We update current understanding of VITT and potential involvement of anti-PF4 antibodies in thrombotic disorders.
在 COVID-19 疫苗接种运动的头几个月中，发现先前健康的接种者在接种基于腺病毒载体的疫苗后通常会发生严重的血栓形成（通常是脑和/或内脏血管）和血小板减少症。这种综合征与疫苗诱导的免疫性血栓性血小板减少症（VITT）之间存在相似性，以及肝素诱导的血小板减少症促使人们认识到抗血小板因子 4（PF4）抗体的作用，并基于静脉内免疫球蛋白和非肝素抗凝剂制定了治疗策略，从而改善了预后。我们更新了对 VITT 的现有认识以及抗-PF4 抗体在血栓性疾病中的潜在作用。
