{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:04:08Z","timestamp":1774343048949,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,2]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>A 47-year-old woman presented with a headache to the acute medical unit, 10 days after receiving AstraZeneca vaccination for COVID-19. Brain imaging was normal, but her blood tests showed a remarkably low platelet count, mildly deranged liver function tests and a high D-dimer. Further within her hospital admission, she developed right-sided abdominal pain and chest pain, and subsequent cross-sectional imaging confirmed a small segmental pulmonary embolism, and an acute portal vein thrombosis extending to the splenic and superior mesenteric veins. On the basis of her investigations, she was diagnosed as a case of vaccine-induced thrombotic thrombocytopenia and was treated with intravenous immunoglobulins. In a time where there is a strategic goal to vaccinate the global population from COVID-19 to inhibit the spread of infection and reduce hospitalisation, this particular clinical scenario emphasises the need of all clinicians to remain vigilant for rare complications of the COVID-19 vaccination.<\/jats:p>","DOI":"10.1136\/bcr-2021-244223","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T12:05:24Z","timestamp":1631880324000},"page":"e244223","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["A rare case of COVID-19 vaccine-induced thrombotic thrombocytopaenia (VITT) involving the veno-splanchnic and pulmonary arterial circulation, from a UK district general hospital"],"prefix":"10.1136","volume":"14","author":[{"given":"Huma","family":"Asmat","sequence":"first","affiliation":[{"name":"Gastroenterology, Bedford Hospital NHS Trust, Bedford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Folusho","family":"Fayeye","sequence":"additional","affiliation":[{"name":"Bedford Hospital NHS Trust, Bedford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hameed","family":"Alshakaty","sequence":"additional","affiliation":[{"name":"General\/Acute Medicine, Bedford Hospital NHS Trust, Bedford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Patel","sequence":"additional","affiliation":[{"name":"Gastroenterology, Bedford Hospital NHS Trust, Bedford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"2025082800022803000_14.9.e244223.1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i1.9397"},{"key":"2025082800022803000_14.9.e244223.2","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1002\/jmv.25766","article-title":"Coronavirus disease 2019: what we know?","volume":"92","author":"He","year":"2020","journal-title":"J Med Virol"},{"key":"2025082800022803000_14.9.e244223.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32623-4"},{"key":"2025082800022803000_14.9.e244223.4","unstructured":"Uk Government . Regulatory approval of COVID-19 vaccine AstraZeneca. Available: https:\/\/www.gov.uk\/government\/publications\/regulatory-approval-of-covid-19-vaccine-astrazeneca [Accessed 11 May 2021]."},{"key":"2025082800022803000_14.9.e244223.5","unstructured":"European Medicines Agency . Ema recommends COVID-19 vaccine AstraZeneca for authorisation in the EU. Available: https:\/\/www.ema.europa.eu\/en\/news\/ema-recommends-covid-19-vaccine-astrazeneca-authorisation-eu [Accessed 11 May 2021]."},{"key":"2025082800022803000_14.9.e244223.6","doi-asserted-by":"crossref","unstructured":"Oldenburg J , Klamroth R , Langer F . Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: guidance statement from the GTH. Hamostaseologie 2021.","DOI":"10.1055\/a-1469-7481"},{"key":"2025082800022803000_14.9.e244223.7","article-title":"Vaccine-Induced immune thrombotic thrombocytopenia (VITT): targeting pathomechanisms with Bruton tyrosine kinase inhibitors","author":"von Hundelshausen","year":"2021","journal-title":"Thromb Haemost"},{"key":"2025082800022803000_14.9.e244223.8","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"N Engl J Med"},{"key":"2025082800022803000_14.9.e244223.9","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1056\/NEJMoa2104882","article-title":"Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination","volume":"384","author":"Schultz","year":"2021","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082800022803000_14.9.e244223.10","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(21)00871-0","article-title":"Pulmonary embolism and thrombocytopenia following ChAdOx1 vaccination","volume":"397","author":"Muster","year":"2021","journal-title":"Lancet"},{"key":"2025082800022803000_14.9.e244223.11","unstructured":"British Society for Haematology . Guidance produced from the expert haematology panel (Ehp) focussed on Covid-19 vaccine induced thrombosis and thrombocytopenia (VITT). Available: https:\/\/b-s-h.org.uk\/media\/19530\/guidance-version-13-on-mngmt-of-thrombosis-with-thrombocytopenia-occurring-after-c-19-vaccine_20210407.pdf [Accessed 11 May 2021]."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:02:38Z","timestamp":1756364558000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":11,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,17]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/bcr-2021-244223"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244223","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}