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Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector‐based COVID‐19 vaccine
Author(s) -
Blauenfeldt Rolf Ankerlund,
Kristensen Søren Risom,
Ernstsen Siw Leiknes,
Kristensen Claudia Christina Hilt,
Simonsen Claus Ziegler,
Hvas AnneMette
Publication year - 2021
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.15347
Subject(s) - medicine , stroke (engine) , magnetic resonance imaging , cardiology , angiography , surgery , radiology , mechanical engineering , engineering
We describe the first Danish case of presumed inflammatory and thrombotic response to vaccination with an adenoviral (ChAdOx1) vector‐based COVID‐19 vaccine (AZD1222). The case describes a 60‐year‐old woman who was admitted with intractable abdominal pain 7 days after receiving the vaccine. Computed tomography of the abdomen revealed bilateral adrenal hemorrhages. On the following day, she developed a massive right‐sided ischemic stroke and magnetic resonance imaging angiography showed occlusion of the right internal carotid artery. The ischemic area was deemed too large to offer reperfusion therapy. During admission, blood tests showed a remarkable drop in platelet counts from 118,000 to 5000 per μl and a substantial increase in D‐dimer. The patient died on the sixth day of hospitalization. Blood tests revealed platelet factor 4 reactive antibodies, imitating what is seen in heparin‐induced thrombocytopenia. This may be a novel immune‐mediated response to the vaccine.