Vaccine-Induced Immune Thrombotic Thrombocytopenia with Disseminated Intravascular Coagulation and Death following the ChAdOx1 nCoV-19 Vaccine

Saudi Arabia, 30 September 2021, Aladdin et al, Journal of Stroke and Cerebrovascular Diseases

Summary

We report a fatal case of vaccine-induced immune thrombotic thrombocytopenia (VITT) in a 36 year old lady, after receiving the first dose of the ChAdOx1 nCoV-19 vaccine.

CT-venogram demonstrated extensive dural venous sinus thrombosis of the superior sagittal sinus and its cortical tributaries as well as the proximal left transverse sinus (Fig. 2 ). CT abdomen and pelvis showed extensive portal vein thrombosis with superior mesenteric vein thrombosis and potential splenic and hepatic infarction. The patient had a complicated course in the ICU given her multiple thromboses, DIC, difficulty to use anticoagulants, lactic acidosis, acute kidney injury, and multi-organ failure. She developed cardiac arrest with pulseless electrical activity and died four days after admission.

Fig. 2
Brain computed tomography scan showing bilateral variable-sized hypodensities in the cerebral hemispheres involving the frontal and parietal lobes bilaterally with loss of gray-white matter differentiation. The CT-venogram is demonstrating extensive dural venous sinus thrombosis of the superior sagittal sinus and its cortical tributaries as well as the proximal left transverse sinus.

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