RT Journal Article
SR Electronic
T1 Cerebral venous sinus thrombosis after ChAdOx1 vaccination: the first case of definite thrombosis with thrombocytopenia syndrome from India
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e246455
DO 10.1136/bcr-2021-246455
VO 14
IS 10
A1 Boby Varkey Maramattom
A1 Fathima Mihta Moidu
A1 Sajira Varikkottil
A1 Akheel A Syed
YR 2021
UL http://casereports.bmj.com/content/14/10/e246455.abstract
AB Cerebral venous sinus thrombosis (CVST) following novel coronavirus-2019 (nCoV-19) vaccination is a rare adverse effect. We report the first case of CVST associated with ChAdOx1 vaccination, with positive anti-platelet factor 4 (PF4) antibodies, from India. A 44-year-old woman developed a thunderclap headache 4 days after the first dose of the adenoviral vector vaccine ChAdOx1 (Covishield). Physical examination was unremarkable barring mild neck stiffness with no focal neurological deficits. MRI identified right transverse sinus thrombosis. Laboratory tests revealed raised D-dimer and thrombocytopenia; anti-PF4 antibodies were subsequently identified, consistent with thrombosis with thrombocytopenia syndrome (TTS). She was treated with non-heparin anticoagulation and intravenous immunoglobulin and made an uneventful recovery. Early recognition of adenoviral vector vaccine-related TTS, which resembles heparin-induced thrombocytopenia syndrome, is important as heparin and heparin analogues are best avoided in the treatment.