Case Series

A Single-Centre Experience of Post-COVID-19 Vaccine-Related Immune-Mediated Complications

Table 1

A summary of the patients included in this case series.

CasesDiagnosisPresenting featuresLaboratory findingsManagementPlatelet recovery timeOutcome

Case 1Definite VITT2Headaches and critical limb ischemiaPlatelet count: 16 × 109/L. D-dimer: 36.00 ug/ml. fibrinogen: 2.6 g/L.Anti-PF4 antibodies: 0.285IVIg x2
Dexamethasone
Argatroban IVI
Surgical intervention
Aspirin and rivaroxaban postoperatively
6 daysTransfemoral above-knee amputation. Anti-PF4 antibodies were not detected at 28 days

Case 2Pre VITT/Probable VITT2Headaches and myalgiaPlatelet count: 20 × 109/L. D-dimer: 54.30 ug/ml. fibrinogen: 1.3 g/L. Anti-PF4 antibodies: 0.245IVIg
Fondaparinux
6 months rivaroxaban
7 days6 months rivaroxaban. Anti-PF4 antibodies were not detected at 35 days

Case 3Vaccine-associated ITPMucocutaneous bleedingPlatelet count: 5 × 109/L. D-dimer: 1.03 ug/ml. Anti-PF4 antibodies: 0.247IVIg
Dexamethasone
Prednisolone
Eltrombopag
No full recovery of platelets when case series writtenContinuous prednisolone and eltrombopag

Case 4Vaccine-associated ITPMucocutaneous bleedingPlatelet count: 1 × 109/L. D-dimer: 1.87 ug/ml. Anti-PF4 antibodies: 0.285IVIg
Dexamethasone
Prednisolone
Eltrombopag
No full recovery of platelets when case series writtenWeaning regime of prednisolone. Eltrombopag was discontinued

Case 5Vaccine-associated ITPHeadaches and mucocutaneous bleedingPlatelet count: 26 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.734IVIg
Dexamethasone
Prednisolone
8 days (relapsed on day 15)Weaning regime of prednisolone

Case 6Vaccine-associated ITPPetechiaePlatelet count: 16 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.070IVIg
Dexamethasone
7 daysFull recovery; off treatment

Case 7Vaccine-associated ITPPetechiae and mucocutaneous bleedingPlatelet count: 1 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.172IVIg
Dexamethasone
2nd dose IVIg
28 daysFull recovery; off treatment