• 제목/요약/키워드: Immunoglobulin G antibodies against platelet factor 4

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Thalamic hemi-chorea: a rare complication after receiving the adenoviral vector-based COVID-19 vaccine: a case report

  • Hamze Shahali;Ramin Hamidi Farahani;Ali Asgari;Ebrahim Hazrati
    • Clinical and Experimental Vaccine Research
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    • 제11권2호
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    • pp.217-221
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    • 2022
  • Lacunar strokes occur when a branch of a large cerebral artery is blocked. The thalamus is often affected, causing uncontrollable motions. A 72-year-old previously healthy man presented with involuntary motions in the right limbs, which were present at rest, and exacerbated during voluntary actions. He had received the first dose of the adenoviral vector-based coronavirus disease 2019 vaccine (ChAdOx1 nCoV-19) 9 days ago. Severe thrombocytopenia and elevated levels of lactate dehydrogenase, ferritin, C-reactive protein, and D-dimer were found, without any evidence of connective tissue disease. Electromyography demonstrated typical choreiform movements, and the brain magnetic resonance imaging indicated a small high signal lesion on the left side of the thalamus. Detection of the immunoglobulin G antibodies against platelet factor 4 in the blood, negative heparin-induced platelet activation (HIPA) test, and positive modified HIPA test confirmed the thalamic stroke due to the vaccine-induced prothrombotic immune thrombocytopenia (VIPIT). He was admitted to the intensive care unit and received nadroparin, sodium ozagrel, edaravone, methylprednisolone, and haloperidol. His hemi-chorea improved gradually over 2 weeks, and he was discharged after 21 days with rehabilitation advice. VIPIT due to the ChAdOx1 nCoV-19 is a novel immune-mediated response that needs clinicians' awareness and further investigations.

대동맥 박리증 수술 후 발생한 혈전증을 동반한 헤파린 기인성 혈소판 감소증의 치료 (The Management of Heparin-induced Thrombocytopenia with Thrombosis That Developed after Aortic Dissection Surgery)

  • 김재범;박남희;최세영
    • Journal of Chest Surgery
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    • 제43권5호
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    • pp.538-541
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    • 2010
  • 헤파린 기인성 혈소판 감소증은 헤파린과 혈소판 제4인자 사이의 복합체에 대항하여 만들어진 면역글로불린-G 항체에 의해 발생한 약물 부작용이라고 할 수 있다. 혈전증을 동반한 헤파린 기인성 혈소판 감소증은 사지 절단이나 뇌졸증, 심근경색과 같은 병을 일으켜 사망에 이르게 할 수 있다. 저자들은 혈전증을 동반한 혈소판 감소증을 agatroban을 사용하여 성공적으로 치료하여 보고하는 바이다.