ChAdOx1 COVID-19 vaccine-induced thrombocytopenia syndrome

Wang, Y -H; Huang, L -Y; Chen, Y -L; Chan, J -S; Chiang, W -F; Lin, C -Y; Chen, M -H; Shyu, H -Y; Hsiao, P -J

COVID-19 vaccine remains critical to control the severe acute respiratory syndrome coronavirus 2 (SARS CoV 2), early recognition and management for COVID-19 vaccine associated side effects are imperative for physicians. COVID-19 vaccine-induced thrombosis with thrombocytopenia syndrome (TTS) is one of potential life-threating complication. The pathophysiology of TTS is presumably the development of antibodies against platelet factor 4 (PF4), further resulting in platelet consumption, depletion, and thrombus formation. COVID-19 vaccine-induced TTS has been reported as a very rare complication after the ChAdOx1 nCoV-19 (AstraZeneca) vaccination and usually manifesting as cerebral venous thrombosis or pulmonary artery embolism. Comparison with stroke and pulmonary embolism, TTS associated intra-abdominal thrombosis is less common. We report a rare case of abdominal pain after the first-dose ChAdOx1 COVID-19 (AstraZeneca) vaccination, the final diagnosis is TTS complicated by hepatic vein thrombosis. Early diagnosis and timely management strategies for TTS are required.