Kataria Saurabh, Reza Rezaur Rahman, Agboola Adesola A, Mohamed Khalid H, Mohamed Alaa S, Zahid Nimra, Haseeb Muhammad, Nasir Hira
Neurology, Ochsner Louisiana State University Health Sciences Center, Shreveport, USA.
Clinical Observation and Research - Neurology and Neurocritical Care, University of Missouri Health Care, Columbia, USA.
Cureus. 2023 Jan 27;15(1):e34272. doi: 10.7759/cureus.34272. eCollection 2023 Jan.
Mass vaccination against coronavirus disease 2019 (COVID-19) has been safe and effective. The ongoing emergence of vaccine-induced complications has challenged the public trust in vaccination programs and, though uncommon, can lead to significant morbidity and mortality. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare and fatal complication of the COVID-19 vaccine. We present a rare case of VITT in a young female who presented with worsening headache, body rash with deteriorating neurological deficit after 12 days of the second dose of the ChAdOx1 COVID-19 vaccine. Initial blood tests showed thrombocytopenia with deranged clotting time and D-dimer levels. Her computed tomography venogram showed thrombosis in the left transverse sinus, and she was diagnosed with a provisional diagnosis of VITT. She initially managed with dexamethasone, intravenous immunoglobulins, and apixaban to reverse the autoimmune process. Our case highlights the clinical course, diagnosis, and management of VITT, which will assist physicians in the timely recognition and adequate management of VITT.
2019冠状病毒病(COVID-19)大规模疫苗接种已证明是安全有效的。疫苗引发的并发症不断出现,这对公众对疫苗接种计划的信任构成了挑战,尽管此类情况并不常见,但可能导致严重的发病和死亡。疫苗诱导的免疫性血小板减少症和血栓形成(VITT)是COVID-19疫苗的一种罕见且致命的并发症。我们报告了一例年轻女性的罕见VITT病例,该患者在接种第二剂ChAdOx1 COVID-19疫苗12天后出现头痛加重、身体皮疹,并伴有神经功能缺损恶化。初步血液检查显示血小板减少,凝血时间和D-二聚体水平异常。她的计算机断层扫描静脉造影显示左侧横窦血栓形成,初步诊断为VITT。她最初接受地塞米松、静脉注射免疫球蛋白和阿哌沙班治疗,以逆转自身免疫过程。我们的病例突出了VITT的临床过程、诊断和管理,这将有助于医生及时识别和妥善处理VITT。