"Introduction
... Thrombocytopenia is one of the rare side effects that have been linked to SARS-CoV-2 vaccination. In some vaccinated individuals, the thrombocytopenia has also been associated with thrombosis. This review addresses what is currently known about SARS-CoV-2 vaccination-induced thrombotic thrombocytopenia (VITT)...
Pathophysiology
... What can be said at this point is that the totality of available evidence implies that VITT is an immune-mediated disorder that leads to the widespread activation of platelets and the coagulation system. However, completely speculative at this point are the components of these adenovirus vector–based vaccines that induce this autoimmune reaction...
Clinical Presentation and Diagnosis
... D-dimer levels are usually quite elevated, and fibrinogen levels are low... [M]any of the initially recognized patients were young women who developed thrombi in unusual places, such as in the cerebral venous sinus or in the splanchnic vessels. It is currently recognized that patients can be of any age or gender, and they more commonly present with deep venous thrombi in the lower extremities or with pulmonary emboli. In approximately 20% of cases, arterial thrombi are present...
Final Comments
It is important to keep in mind that thrombi are both common (up to 900,000 per year in the United States alone) and potentially lethal, causing 50,000–100,000 deaths per year in the United States."
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