{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:23:33Z","timestamp":1777940613040,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>The accelerated development of various vaccines against COVID-19 was a global effort to curb the COVID-19 pandemic. As a result, several unique vaccine-related adverse events were observed. Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been recognised as a clinically distinct entity with a predisposition for thrombosis at unusual sites with laboratory features of consumptive coagulopathy in addition to anti-PF4 assay seropositivity. The majority of cases reported were associated with adenoviral-based vectors such as ChAdOx1 nCoV-19 (Oxford-AstraZeneca) and Janssen Ad26.COV2.S (Johnson &amp; Johnson). In our online search, we have not found any reports to date of VITT associated with Pfizer\u2013BioNTech Comirnaty mRNA vaccine. We report a case of a previously healthy 76-year-old man who received his first-dose Pfizer Comirnaty vaccine on 11 October 2021 who developed left upper limb swelling on day 2 post-vaccination, which progressively worsened on day 4 post-vaccination. He was confirmed to have left axillary vein thrombosis on computer tomography arteriography\/computed tomography venography of left upper limb on day 5 post-vaccination with new onset aphasia with unilateral limb weakness on day 8 post-vaccination. Magnetic resonance imaging\/magnetic resonance angiography of the brain confirmed acute left middle cerebral artery thrombosis with infarction. Blood investigations showed thrombocytopenia, elevated D-dimer, hypofibrinogenemia in addition to his unusual sites of thrombosis involving both arterial and venous circulation. His IgG ELISA assay for anti-PF4 antibody was positive.<\/jats:p>","DOI":"10.1177\/14782715221103660","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T08:56:17Z","timestamp":1655456177000},"page":"113-116","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["A probable case of vaccine-induced immune thrombotic thrombocytopenia secondary to Pfizer Comirnaty COVID-19 vaccine"],"prefix":"10.1177","volume":"52","author":[{"given":"Carol","family":"Goh CY","sequence":"first","affiliation":[{"name":"Haematology Unit, Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chew","family":"Teng Keat","sequence":"additional","affiliation":[{"name":"Haematology Unit, Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiang","family":"Su Kien","sequence":"additional","affiliation":[{"name":"Haematology Unit, Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goh","family":"Ai Sim","sequence":"additional","affiliation":[{"name":"Haematology Unit, Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"bibr1-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012152"},{"key":"bibr2-14782715221103660","author":"Bussel JB","year":"2021","journal-title":"Thrombosis with thrombocytopenia syndrome (also termed vaccine-induced thrombotic thrombocytopenia)"},{"key":"bibr3-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012217"},{"key":"bibr4-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109908"},{"key":"bibr5-14782715221103660","unstructured":"Medicines and Healthcare Products Regulatory Agency. Research and analysis: Coronavirus vaccine\u2014weekly summary of Yellow Card reporting. Updated 24 December 2021. https:\/\/www.gov.uk\/government\/publications\/coronavirus-covid-19-vaccine-adverse-reactions\/coronavirus-vaccine-summary-of-yellow-card-reporting (2021, assessed 3 January 2022)."},{"key":"bibr6-14782715221103660","unstructured":"Centers for Disease Control and Prevention Emergency Preparedness and Response. Johnson & Johnson\/Janssen COVID-19 Vaccine and Thrombosis with Thrombocytopenia Syndrome (TTS): Update for Clinicians. https:\/\/emergency.cdc.gov\/coca\/calls\/2021\/callinfo_042721.asp (2020, assessed 31 January 2022)."},{"key":"bibr7-14782715221103660","doi-asserted-by":"publisher","DOI":"10.7326\/L21-0244"},{"key":"bibr8-14782715221103660","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9111326"},{"key":"bibr9-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104840"},{"key":"bibr10-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.03025.x"},{"key":"bibr11-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03744-4"},{"key":"bibr12-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104882"},{"key":"bibr13-14782715221103660","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2105385"}],"container-title":["Journal of the Royal College of Physicians of Edinburgh"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14782715221103660","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14782715221103660","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14782715221103660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:55:25Z","timestamp":1777701325000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14782715221103660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1177\/14782715221103660"],"URL":"https:\/\/doi.org\/10.1177\/14782715221103660","relation":{},"ISSN":["1478-2715","2042-8189"],"issn-type":[{"value":"1478-2715","type":"print"},{"value":"2042-8189","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}