Rapid progressive vaccine-induced immune thrombotic thrombocytopenia with cerebral venous thrombosis after ChAdOx1 nCoV-19(AZD1222)vaccination:A case report

作     者：Shin-Kuang Jiang Wei-Liang Chen Chun Chien Chi-Syuan Pan Sheng-Ta Tsai 

作者机构：Department of NeurologyChina Medical University HospitalTaichung 404332Taiwan Department of RadiologyChina Medical University HospitalTaichung 404332Taiwan Department of NeurologyChina Medical University Hsinchu HospitalHsinchu 30272Taiwan Department of EmergencyChina Medical University HospitalTaichung 404332Taiwan Neuroscience and Brain Disease CenterChina Medical UniversityTaichung 404332Taiwan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2022年第10卷第26期

页      面：9462-9469页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100204[医学-神经病学] 10[医学] 

主　　题：Vaccine-induced immune thrombotic thrombocytopenia Intracranial Sinus Thrombosis ChAdOx1 nCoV-19 vaccine(AZD1222) Headache Serial brain image Case report 

摘      要：BACKGROUND Vaccine-induced immune thrombotic thrombocytopenia(VITT)is a rare and potentially life-threatening condition after receiving coronavirus disease *** is characterized by symptom onset at 5 to 30 d postvaccination,thrombocytopenia,thrombosis,high D-dimer level,and antiplatelet factor 4(anti-PF4)antibody *** can progress very fast,requiring urgent *** few studies have described its detailed clinical course and imaging *** report a typical VITT case in a patient who underwent regular repeated brain imaging *** SUMMARY A young woman presented with headaches at 7 d after the ChAdOx1 nCoV-19vaccine(AZD1222)*** then showed progressive symptoms of left upper limb *** computed tomography revealed venous infarction at the right parietal lobe with a hyperacute thrombus in the cortical *** hours later,brain magnetic resonance imaging revealed hemorrhage at the same *** resonance venography showed an irregular contour of the right transverse *** examination revealed a high D-dimer level,thrombocytopenia,and a high titer for anti-PF4 *** was treated with anticoagulants,intravenous immunoglobulin,and steroids and analgesic agents were administered for pain *** had a marked improvement on headaches and clumsiness after treatment along with radiological thrombus *** follow-up at the outpatient department,her modified Rankin scale at 90 d was *** Clinicians should be alerted whenever patients present with persistent and progressive headaches or focal motor/sensory deficits postvaccination.