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Haematuria, a widespread petechial rash, and headaches following the Oxford AstraZeneca ChAdOx1 nCoV-19 Vaccination
  1. Ammar Waraich and
  2. George Williams
  1. Department of Acute Medicine, Worcestershire Acute Hospitals NHS Trust, Worcester, Worcestershire, England, UK
  1. Correspondence to Dr Ammar Waraich; ammarwaraich{at}


With increasing presentations of headaches following COVID-19 vaccination, we present one of the UK’s earliest proven cases of vaccine-induced thrombotic thrombocytopaenia (VITT), with the aim of giving colleagues a case to compare other patients against. Our patient was a 48-year-old man who presented with frank haematuria, a widespread petechial rash, and headaches, 2 weeks after receiving the first dose of the Oxford AstraZeneca ChAdOx1 nCoV-19 vaccine. He had a platelet count of 14×109/L and an extensive cerebral venous sinus thrombosis (CVST) with subarachnoid haemorrhage on imaging. He developed localising neurological signs and experienced a cardiopulmonary arrest. He was successfully resuscitated and transferred to a tertiary care centre for urgent thrombectomy. This case illustrates how the diagnosis of VITT should be based on the platelet count and imaging—and how patients with VITT should be cared for in centres with urgent neurosurgical and interventional radiology services.

  • COVID-19
  • emergency medicine
  • general practice / family medicine
  • haematology (incl blood transfusion)
  • public health

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  • Contributors GW wrote the initial case report draft and acquired patient results and consent. AW rewrote the draft into the final version, and added the remaining sections to the report, including summary, investigations, discussion and lessons. He also acquired additional results, haematological results, and images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.