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新冠疫苗接种后发生的脑静脉窦血栓形成和免疫性血小板减少症:一例报告及病例分析

Cerebral Sinus Thrombosis and Immune Thrombocytopenia Post COVID-19 Vaccination: A Case Report and Narrative Review.

作者信息

Ali Azka, Dilibe Arthur, Rai Shilpa, Awosika Ayoola, Omole Adekunle E, Ahmed Maryam, Nwosu Stella

机构信息

Internal Medicine, Rosalind Franklin University of Medicine and Sciences, Chicago, USA.

Internal Medicine, East Carolina University Health, Greenville, USA.

出版信息

Cureus. 2023 Feb 2;15(2):e34550. doi: 10.7759/cureus.34550. eCollection 2023 Feb.

Abstract

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) following the adenoviral vector COVID-19 vaccine is a rare adverse event. Although the risk of VITT following the COVID-19 vaccine appears to be low, early diagnosis and management can be lifesaving. We present a case of VITT in a young female who presented with persistent headaches and fevers followed by anisocoria and right-sided hemiplegia. Initial imaging was unremarkable, and labs showed thrombocytopenia and elevated d-dimers. Repeat imaging revealed thrombosis in the left transverse and superior sagittal sinuses, and she was diagnosed with VITT. She received combined treatment with intravenous immunoglobulins and systemic anticoagulation, resulting in an increased platelet count and resolution of her neurological symptoms.

摘要

接种腺病毒载体新冠疫苗后发生的疫苗诱导的免疫性血小板减少症和血栓形成(VITT)是一种罕见的不良事件。尽管接种新冠疫苗后发生VITT的风险似乎较低,但早期诊断和治疗可能挽救生命。我们报告一例年轻女性VITT病例,该患者最初出现持续性头痛和发热,随后出现瞳孔不等大和右侧偏瘫。初始影像学检查无明显异常,实验室检查显示血小板减少和D-二聚体升高。重复影像学检查发现左侧横窦和上矢状窦血栓形成,她被诊断为VITT。她接受了静脉注射免疫球蛋白和全身抗凝联合治疗,血小板计数增加,神经症状得到缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8514/9985429/214a7d095d36/cureus-0015-00000034550-i01.jpg

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