Figure 1. Clinical course of TTSs.... | American Society of Hematology

Figure 1.

$Clinical course of TTSs. Platelet counts (black line) D-dimer levels (blue line) and the clinical course of 2 index patients with anti-PF4–negative TTS after mRNA-based vaccination against COVID-19. (A) Index case 1: 57-year-old male with a history of kidney transplantation in 2009 and a recent COVID-19 infection with progressive thrombosis of the right femoral vein. Despite antithrombotic triple therapy, immunosuppression, and high-dose IVIG, only immunoadsorption was able to control the situation and resulted in a sustained platelet count increase. (B) Index case 2: 37-year-old male with a history of Hodgkin lymphoma in remission and prior episodes of ITP with petechiae, headache, thrombocytopenia, and elevated D-dimer. IVIG was administered to stabilize platelet counts but the patient developed pulmonary embolism and splanchnic vein thrombosis. Therapeutic dose anticoagulation, immunosuppression, and plasma exchange increased platelet counts without further thromboembolic events. LMWH, low-molecular-weight heparin; UFH, unfractionated heparin; VKA, vitamin K antagonists.$

Clinical course of TTSs. Platelet counts (black line) D-dimer levels (blue line) and the clinical course of 2 index patients with anti-PF4–negative TTS after mRNA-based vaccination against COVID-19. (A) Index case 1: 57-year-old male with a history of kidney transplantation in 2009 and a recent COVID-19 infection with progressive thrombosis of the right femoral vein. Despite antithrombotic triple therapy, immunosuppression, and high-dose IVIG, only immunoadsorption was able to control the situation and resulted in a sustained platelet count increase. (B) Index case 2: 37-year-old male with a history of Hodgkin lymphoma in remission and prior episodes of ITP with petechiae, headache, thrombocytopenia, and elevated D-dimer. IVIG was administered to stabilize platelet counts but the patient developed pulmonary embolism and splanchnic vein thrombosis. Therapeutic dose anticoagulation, immunosuppression, and plasma exchange increased platelet counts without further thromboembolic events. LMWH, low-molecular-weight heparin; UFH, unfractionated heparin; VKA, vitamin K antagonists.

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