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Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
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논문 기본 정보

Type
Academic journal
Author
Choi Jae-Ki (Division of Infectious Diseases Department of Internal Medicine Bucheon St. Mary's Hospital College) Kim Sunghan (Department of Neurosurgery Bucheon St. Mary's Hospital College of Medicine The Catholic University) Kim Seo Ree (Division of Hematology/Oncology Department of Internal Medicine Bucheon St. Mary's Hospital College)
Journal
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.31 KCI Accredited Journals
Published
2021.1
Pages
1 - 6 (6page)

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Intracerebral Hemorrhage due to Thrombosis with Thrombocytopenia Syndrome after Vaccination against COVID-19: the First Fatal Case in Korea
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Vaccination with an adenoviral vector vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in the rare development of thrombosis with thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4). This is a life-threating condition that may be accompanied by bleeding due to thrombocytopenia with thrombosis of the cerebral venous sinus or splanchnic vein. Herein, we describe the first fatal case of thrombosis with thrombocytopenia syndrome in Korea, presenting with intracranial hemorrhage caused by cerebral venous sinus thrombosis. A 33-year-old Korean man received the first dose of the ChAdOx1 nCoV-19 vaccination. He developed severe headache with vomiting 9 days after the vaccination. Twelve days after vaccination, he was admitted to the hospital with neurological symptoms and was diagnosed with cerebral venous sinus thrombosis, which was accompanied by intracranial hemorrhage. Thrombocytopenia and D-dimer elevation were observed, and the result of the PF4 enzymelinked immunosorbent assay antibody test was reported to be strongly positive. Despite intensive treatment, including intravenous immunoglobulin injection and endovascular mechanical thrombectomy, the patient died 19 days after vaccination. Physicians need to be aware of thrombosis with thrombocytopenia syndrome (TTS) in adenoviral vector-vaccinated patients. Endovascular mechanical thrombectomy might be a useful therapeutic option for the treatment of TTS with cerebral venous sinus thrombosis.
#COVID-19 Vaccines #Platelet Factor 4 #Intracranial Sinus Thrombosis #Endovascular Procedures #Mechanical Thrombolysis

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References (9)

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유진홍 / 2021 / What We Do Know and Do Not Yet Know about COVID-19 Vaccines as of the Beginning of the Year 2021 / Journal of Korean Medical Science 36(6):1~17 Crossref Greinacher A / 2021 / Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination / N Engl J Med 384(22):2092~2101 google schola Scully M / 2021 / Pathologic antibodies to platelet factor 4after ChAdOx1 nCoV-19 vaccination / N Engl J Med 384(23):2202~2211 google schola Franchini M / 2021 / COVID-19 vaccine-associated immune thrombosis and thrombocytopenia(VITT) : Diagnostic and therapeutic recommendations for a new syndrome / Eur J Haematol 107(2):173~180 google schola Huh Kyungmin / 2021 / Predicted and Observed Incidence of Thromboembolic Events among Koreans Vaccinated with ChAdOx1 nCoV-19 Vaccine / Journal of Korean Medical Science 36(27):1~6 dbpia

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