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Cases | Diagnosis | Presenting features | Laboratory findings | Management | Platelet recovery time | Outcome |
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Case 1 | Definite VITT2 | Headaches and critical limb ischemia | Platelet count: 16 × 109/L. D-dimer: 36.00 ug/ml. fibrinogen: 2.6 g/L.Anti-PF4 antibodies: 0.285 | IVIg x2 Dexamethasone Argatroban IVI Surgical intervention Aspirin and rivaroxaban postoperatively | 6 days | Transfemoral above-knee amputation. Anti-PF4 antibodies were not detected at 28 days |
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Case 2 | Pre VITT/Probable VITT2 | Headaches and myalgia | Platelet count: 20 × 109/L. D-dimer: 54.30 ug/ml. fibrinogen: 1.3 g/L. Anti-PF4 antibodies: 0.245 | IVIg Fondaparinux 6 months rivaroxaban | 7 days | 6 months rivaroxaban. Anti-PF4 antibodies were not detected at 35 days |
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Case 3 | Vaccine-associated ITP | Mucocutaneous bleeding | Platelet count: 5 × 109/L. D-dimer: 1.03 ug/ml. Anti-PF4 antibodies: 0.247 | IVIg Dexamethasone Prednisolone Eltrombopag | No full recovery of platelets when case series written | Continuous prednisolone and eltrombopag |
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Case 4 | Vaccine-associated ITP | Mucocutaneous bleeding | Platelet count: 1 × 109/L. D-dimer: 1.87 ug/ml. Anti-PF4 antibodies: 0.285 | IVIg Dexamethasone Prednisolone Eltrombopag | No full recovery of platelets when case series written | Weaning regime of prednisolone. Eltrombopag was discontinued |
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Case 5 | Vaccine-associated ITP | Headaches and mucocutaneous bleeding | Platelet count: 26 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.734 | IVIg Dexamethasone Prednisolone | 8 days (relapsed on day 15) | Weaning regime of prednisolone |
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Case 6 | Vaccine-associated ITP | Petechiae | Platelet count: 16 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.070 | IVIg Dexamethasone | 7 days | Full recovery; off treatment |
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Case 7 | Vaccine-associated ITP | Petechiae and mucocutaneous bleeding | Platelet count: 1 × 109/L. D-dimer: not elevated. Anti-PF4 antibodies: 0.172 | IVIg Dexamethasone 2nd dose IVIg | 28 days | Full recovery; off treatment |
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