Table 1. Clinical characteristics of the... | American Society of Hematology

Table 1.

Clinical characteristics of the 9 patients with VITT-like prothrombotic disease without proximate exposure to heparin or vaccination

	Patient 1∗	Patient 2†	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7	Patient 8‡	Patient 9
Sex, age (y)	Female, 70-80 y	Female, 30-40 y	Female, 70-80 y	Male, 60-70 y	Female, 20-30 y	Female, 30-40 y	Male, 60-70 y	Male, 20-30 y	Male, 5-10 y
Symptoms	Variable	Severe Headache	Dyspnea	Neurological symptoms	Common cold, severe headache with hemianopia	N/A	Dyspnea	Severe headache	Severe headache, vomiting, nausea
Diagnosis	Recurrent DVT and PE, stroke over 3 y	CVST with secondary bleeding	PE	Stroke with secondary intracranial bleeding	CVST with secondary bleeding, PE, portal vein thrombosis	Recurrent venous and arterial thrombotic events over 13 years, including stroke	Bilateral DVT with PE	CVST with secondary bleeding	CVST
Preceding infection (interval to admission)	—	Common cold (7 d)	—	—	Respiratory syncytial virus (unknown, active at admission)	—	Urinary tract infection (11 d)	Common cold (14 d)	Adenovirus (10 d)
Other underlying disease	Monoclonal gammopathy	—	—	—	—	—	Crohn‘s disease	—	—
Therapy	Multiple anticoagulants and platelet aggregation inhibitors	Argatroban, IVIG	Unfractioned heparin, fondaparinux, apixaban	Plasma exchange, fondaparinux, apixaban	Unfractionated heparin, followed by VKA	Multiple anticoagulants and platelet aggregation inhibitors, over 13 y, IVIG, plasmapheresis	Patient refused further therapy	Unfractioned heparin; followed by fondaparinux; prednisolone	LMWH, rivaroxaban, dexamethasone, acetazolamide
Outcome	PLT count stabilized in lower reference range, lately no further thromboembolism	Fatal	Recovered	Recovered with persistent sequelae from stroke	Recovered	Recurrent relapses	Fatal	Recovered with persistent sequelae from CVST	Recovered

	Patient 1∗	Patient 2†	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7	Patient 8‡	Patient 9
Sex, age (y)	Female, 70-80 y	Female, 30-40 y	Female, 70-80 y	Male, 60-70 y	Female, 20-30 y	Female, 30-40 y	Male, 60-70 y	Male, 20-30 y	Male, 5-10 y
Symptoms	Variable	Severe Headache	Dyspnea	Neurological symptoms	Common cold, severe headache with hemianopia	N/A	Dyspnea	Severe headache	Severe headache, vomiting, nausea
Diagnosis	Recurrent DVT and PE, stroke over 3 y	CVST with secondary bleeding	PE	Stroke with secondary intracranial bleeding	CVST with secondary bleeding, PE, portal vein thrombosis	Recurrent venous and arterial thrombotic events over 13 years, including stroke	Bilateral DVT with PE	CVST with secondary bleeding	CVST
Preceding infection (interval to admission)	—	Common cold (7 d)	—	—	Respiratory syncytial virus (unknown, active at admission)	—	Urinary tract infection (11 d)	Common cold (14 d)	Adenovirus (10 d)
Other underlying disease	Monoclonal gammopathy	—	—	—	—	—	Crohn‘s disease	—	—
Therapy	Multiple anticoagulants and platelet aggregation inhibitors	Argatroban, IVIG	Unfractioned heparin, fondaparinux, apixaban	Plasma exchange, fondaparinux, apixaban	Unfractionated heparin, followed by VKA	Multiple anticoagulants and platelet aggregation inhibitors, over 13 y, IVIG, plasmapheresis	Patient refused further therapy	Unfractioned heparin; followed by fondaparinux; prednisolone	LMWH, rivaroxaban, dexamethasone, acetazolamide
Outcome	PLT count stabilized in lower reference range, lately no further thromboembolism	Fatal	Recovered	Recovered with persistent sequelae from stroke	Recovered	Recurrent relapses	Fatal	Recovered with persistent sequelae from CVST	Recovered

DVT, deep vein thrombosis; PE, pulmonary embolism; VKA, vitamin K antagonists.

∗

Detailed course described in Greinacher et al.²⁰

†

Detailed course described in Greinacher et al.²¹

‡

Detailed course described in Warkentin et al.²²

View Large

This Feature Is Available To Subscribers Only