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Case Reports: Adverse drug reactions and complications
Vaccine-induced immune thrombocytopaenia and thrombosis (VITT) after COVID-19 vaccination
  1. Maria Inês Ribeiro1,
  2. Inês Pimenta1,
  3. Inês Conde2 and
  4. Filipe André Gonzalez1
  1. 1Intensive Care Department, Hospital Garcia de Orta EPE, Almada, Portugal
  2. 2Haematology Department, Hospital Garcia de Orta EPE, Almada, Portugal
  1. Correspondence to Dr Filipe André Gonzalez; filipeandregonzalez{at}gmail.com

Abstract

COVID-19 represents a global health emergency, causing significant morbidity and mortality. Multiple vaccines have been distributed worldwide to control the spread of this pandemic. Several reports of thrombosis and thrombocytopaenia have been described after vaccination. These have been termed vaccine-induced immune thrombocytopaenia and thrombosis (VITT). We report a fatal case of VITT after receiving the first dose of Ad26.COV2.S vaccine. A man in his 30s developed thrombocytopaenia, massive haemoperitoneum due to spleen rupture and extensive portal and femoral vein thrombosis. The patient rapidly developed multiple organ failure and died. We attributed this condition to the vaccine due to the temporal relationship, presence of thrombosis and thrombocytopaenia, high levels of platelet factor 4 antibodies and exclusion of other diagnoses. Healthcare providers should be aware of such rare but fatal complications of COVID-19 immunisation, as early diagnosis of VITT may improve prognosis by allowing timely appropriate treatment.

  • COVID-19
  • Immunological products and vaccines
  • Adult intensive care
  • Unwanted effects / adverse reactions

https://doi.org/10.1136/bcr-2021-247346

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    Footnotes

    • Contributors All authors contributed to the writing of the article and were involved with the patient’s care. MIR: conception of the article, revising intellectual content and drafting of the manuscript. IP contributed to revision of the initial draft. IC: participated in revision of the case. FAG: revising and preparation of the final manuscript. All authors read and approved the final manuscript.

    • 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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