Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination
Report in 23 patients who presented with thrombosis and thrombocytopenia after first dose of Astra Zeneca vaccine notes that 22 were positive for antibodies to platelet factor 4.
Source:
New England Journal of Medicine
SPS commentary:
A related editorial discusses the findings of this study and notes that limited information relating to management of this syndrome suggests that intravenous immune globulin and high-dose glucocorticoids can improve the platelet count within days, which may limit the risk of haemorrhagic transformation, especially when anticoagulation is instituted.
Although the condition in some patients improved when they were given low-molecular-weight heparin, the author advises to choose from among the non-heparin antithrombotic agents that are used to treat heparin-induced thrombocytopenia while the risk of bleeding is being mitigated.
A case report of cerebral venous sinus thrombosis with antibodies against platelet factor 4 has also been reported with the Johnson & Johnson/Janssen vaccine although a causal relationship cannot be established.