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- Title
Vaccine-Induced Immune Thrombotic Thrombocytopenia: Clinicopathologic Features and New Perspectives on Anti-PF4 Antibody-Mediated Disorders.
- Authors
Zhang, Yi; Bissola, Anna-Lise; Treverton, Jared; Hack, Michael; Lychacz, Mark; Kwok, Sarah; Arnold, Addi; Nazy, Ishac
- Abstract
Introduction: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare yet severe adverse complication first identified during the global vaccination effort against SARS-CoV-2 infection, predominantly observed following administration of the ChAdOx1-S (Oxford-AstraZeneca) and Ad26.CoV2.S (Johnson & Johnson/Janssen) adenoviral vector-based vaccines. Unlike other anti-platelet factor 4 (PF4) antibody-mediated disorders, such as heparin-induced thrombocytopenia (HIT), VITT arises with the development of platelet-activating anti-PF4 antibodies 4–42 days post-vaccination, typically featuring thrombocytopenia and thrombosis at unusual sites. Aim: To explore the unique properties, pathogenic mechanisms, and long-term persistence of VITT antibodies in patients, in comparison with other anti-PF4 antibody-mediated disorders. Discussion: This review highlights the complexity of VITT as it differs in antibody behavior and clinical presentation from other anti-PF4-mediated disorders, including the high incidence rate of cerebral venous sinus thrombosis (CVST) and the persistence of anti-PF4 antibodies, necessitating a re-evaluation of long-term patient care strategies. The nature of VITT antibodies and the underlying mechanisms triggering their production remain largely unknown. Conclusion: The rise in awareness and subsequent prompt recognition of VITT is paramount in reducing mortality. As vaccination campaigns continue, understanding the role of adenoviral vector-based vaccines in VITT antibody production is crucial, not only for its immediate clinical implications, but also for developing safer vaccines in the future.
- Subjects
IDIOPATHIC thrombocytopenic purpura; JOHNSON &; Johnson (Company); ASTRAZENECA PLC; ANTIBODY formation; SINUS thrombosis; VENOUS thrombosis; CRANIAL sinuses; ADENOVIRUS diseases; ANTIPHOSPHOLIPID syndrome
- Publication
Journal of Clinical Medicine, 2024, Vol 13, Issue 4, p1012
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm13041012