{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:04:11Z","timestamp":1774343051747,"version":"3.50.1"},"reference-count":15,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,4]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>COVID-19 represents a global health emergency, causing significant morbidity and mortality. Multiple vaccines have been distributed worldwide to control the spread of this pandemic. Several reports of thrombosis and thrombocytopaenia have been described after vaccination. These have been termed vaccine-induced immune thrombocytopaenia and thrombosis (VITT). We report a fatal case of VITT after receiving the first dose of Ad26.COV2.S vaccine. A man in his 30s developed thrombocytopaenia, massive haemoperitoneum due to spleen rupture and extensive portal and femoral vein thrombosis. The patient rapidly developed multiple organ failure and died. We attributed this condition to the vaccine due to the temporal relationship, presence of thrombosis and thrombocytopaenia, high levels of platelet factor 4 antibodies and exclusion of other diagnoses. Healthcare providers should be aware of such rare but fatal complications of COVID-19 immunisation, as early diagnosis of VITT may improve prognosis by allowing timely appropriate treatment.<\/jats:p>","DOI":"10.1136\/bcr-2021-247346","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T11:50:16Z","timestamp":1652961016000},"page":"e247346","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Vaccine-induced immune thrombocytopaenia and thrombosis (VITT) after COVID-19 vaccination"],"prefix":"10.1136","volume":"15","author":[{"given":"Maria In\u00eas","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Intensive Care Department, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6522-8338","authenticated-orcid":false,"given":"In\u00eas","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00eas","family":"Conde","sequence":"additional","affiliation":[{"name":"Haematology Department, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-1092","authenticated-orcid":false,"given":"Filipe Andr\u00e9","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"2025082800564415000_15.5.e247346.1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/ijlh.13629","article-title":"Laboratory testing for suspected COVID-19 vaccine-induced (immune) thrombotic thrombocytopenia","volume":"43","author":"Favaloro","year":"2021","journal-title":"Int J Lab Hematol"},{"key":"2025082800564415000_15.5.e247346.2","doi-asserted-by":"crossref","DOI":"10.3390\/ph14050406","article-title":"COVID-19 vaccines: a review of the safety and efficacy of current clinical trials","volume":"14","author":"Yan","year":"2021","journal-title":"Pharmaceuticals"},{"key":"2025082800564415000_15.5.e247346.3","first-page":"355","article-title":"Addressing vaccine-induced immune thrombotic thrombocytopenia (VITT) following COVID-19 vaccination: a mini-review of practical 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Med"},{"key":"2025082800564415000_15.5.e247346.8","doi-asserted-by":"crossref","DOI":"10.1002\/rmv.2273","article-title":"Vaccine-Induced immune thrombotic thrombocytopenia after vaccination against Covid-19: a clinical dilemma for clinicians and patients","volume":"32","author":"Mohseni Afshar","year":"2022","journal-title":"Rev Med Virol"},{"key":"2025082800564415000_15.5.e247346.9","first-page":"5063","article-title":"Vaccine-Induced severe thrombotic thrombocytopenia following COVID-19 vaccination: a report of an autoptic case and review of the literature","volume":"25","author":"Fanni","year":"2021","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025082800564415000_15.5.e247346.10","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ijid.2022.03.034","article-title":"Thrombosis patterns and clinical outcome of COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a systematic review and meta-analysis","volume":"119","author":"Kim","year":"2022","journal-title":"Int J Infect Dis"},{"key":"2025082800564415000_15.5.e247346.11","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1056\/NEJMe2106315","article-title":"SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia","volume":"384","author":"Cines","year":"2021","journal-title":"N Engl J Med"},{"key":"2025082800564415000_15.5.e247346.12","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/ejh.13665","article-title":"COVID-19 vaccine-associated immune thrombosis and thrombocytopenia (VITT): diagnostic and therapeutic recommendations for a new syndrome","volume":"107","author":"Franchini","year":"2021","journal-title":"Eur J Haematol"},{"key":"2025082800564415000_15.5.e247346.13","unstructured":"Pavord SLW , Makris M , Scully M . Guidance from the expert haematology panel (Ehp) on COVID-19 vaccine-induced immune thrombocytopenia and thrombosis (VITT), 2022. Available: https:\/\/b-s-h.org.uk\/media\/20499\/guidance-version-22-20210903.pdf"},{"key":"2025082800564415000_15.5.e247346.14","unstructured":"Care TNIfHa . COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis (VITT), 2022. Available: https:\/\/www.nice.org.uk\/guidance\/ng200\/resources\/covid19-rapid-guideline-vaccineinduced-immune-thrombocytopenia-and-thrombosis-vitt-pdf-51036811744"},{"key":"2025082800564415000_15.5.e247346.15","doi-asserted-by":"crossref","unstructured":"McCrae KR . Thrombotic thrombocytopenia due to SARS-CoV-2 vaccination. Cleve Clin J Med. 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