{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:38:55Z","timestamp":1778870335073,"version":"3.51.4"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Vaccine-induced immune thrombotic thrombocytopenia is emerging as one of the most relevant side effects of adenoviral-based vaccines against coronavirus disease 2019. Given the novelty of this disease, the medical community is seeking new evidence and clinical experiences on the management of these patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>In this article, we describe the case of a 73-year-old Caucasian woman who presented with diffuse prothrombotic syndrome, both in the arterial and venous districts, following the first dose administration of ChAdOx1 CoV-19 vaccine. The main thrombotic sites included the brain, with both a cortical ischemic lesion and thromboses of the left transverse and sigmoid sinuses and the lower limbs, with deep venous thrombosis accompanied by subsegmental pulmonary thromboembolism. The deep venous thrombosis progressively evolved into acute limb ischemia, requiring surgical intervention with thromboendoarterectomy. Anticoagulation was maintained throughout the whole hospitalization period and continued in the outpatient setting using vitamin K antagonists for a recommended period of 6\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This case describes the management of vaccine-induced immune thrombotic thrombocytopenia in a complicated clinical scenario, including multisite arterial and venous thromboses. Given the complexity of the patient presentation, this case may implement the comprehension of the mechanisms and clinical features of this disease; it also provides a picture of the challenges related to the management, often requiring a multidisciplinary approach.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-03083-y","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T21:42:36Z","timestamp":1633642956000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diffuse prothrombotic syndrome after ChAdOx1 nCoV-19 vaccine administration: a case report"],"prefix":"10.1186","volume":"15","author":[{"given":"Nicole","family":"Ceschia","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Scheggi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Maria","family":"Gori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela Antonietta","family":"Rogolino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Cesari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betti","family":"Giusti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Cipollini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niccol\u00f2","family":"Marchionni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brunetto","family":"Alterini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Marcucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"key":"3083_CR1","unstructured":"COVID-19: Vaccine-induced immune thrombotic thrombocytopenia (VITT)\u2014UpToDate [Internet]. [cited 2021 May 20]. https:\/\/www.uptodate.com\/contents\/covid-19-vaccine-induced-immune-thrombotic-thrombocytopenia-vitt."},{"key":"3083_CR2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104840","author":"A Greinacher","year":"2021","unstructured":"Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med. 2021. https:\/\/doi.org\/10.1056\/NEJMoa2104840.","journal-title":"N Engl J Med"},{"issue":"22","key":"3083_CR3","doi-asserted-by":"publisher","first-page":"2124","DOI":"10.1056\/NEJMoa2104882","volume":"384","author":"NH Schultz","year":"2021","unstructured":"Schultz NH, S\u00f8rvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, et\u00a0al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(22):2124\u201330.","journal-title":"N Engl J Med"},{"key":"3083_CR4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2105385","author":"M Scully","year":"2021","unstructured":"Scully M, Singh D, Lown R, Poles A, Solomon T, Levi M, et\u00a0al. Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021. https:\/\/doi.org\/10.1056\/NEJMoa2105385.","journal-title":"N Engl J Med"},{"key":"3083_CR5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107051","author":"A Bourguignon","year":"2021","unstructured":"Bourguignon A, Arnold DM, Warkentin TE, Smith JW, Pannu T, Shrum JM, et\u00a0al. Adjunct immune globulin for vaccine-induced thrombotic thrombocytopenia. N Engl J Med. 2021. https:\/\/doi.org\/10.1056\/NEJMoa2107051.","journal-title":"N Engl J Med"},{"key":"3083_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-021-02793-x","author":"R Marcucci","year":"2021","unstructured":"Marcucci R, Marietta M. Vaccine-induced thrombotic thrombocytopenia: the elusive link between thrombosis and adenovirus-based SARS-CoV-2 vaccines. Intern Emerg Med. 2021. https:\/\/doi.org\/10.1007\/s11739-021-02793-x.","journal-title":"Intern Emerg Med"},{"key":"3083_CR7","unstructured":"Gresele P, Marietta M, Ageno W, Marcucci R, Contino L, Donadini MP, et\u00a0al. Management of cerebral and splanchnic vein thrombosis associated with thrombocytopenia in subjects previously vaccinated with Vaxzevria (AstraZeneca): a position statement from the Italian Society for the Study of Haemostasis and Thrombosis (SISET). Blood Transfus Trasfus Sangue. 2021."},{"issue":"2","key":"3083_CR8","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1177\/1060028020943542","volume":"55","author":"JA Dougherty","year":"2021","unstructured":"Dougherty JA, Yarsley RL. Intravenous immune globulin (IVIG) for treatment of autoimmune heparin-induced thrombocytopenia: a systematic review. Ann Pharmacother. 2021;55(2):198\u2013215.","journal-title":"Ann Pharmacother"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03083-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-03083-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03083-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T22:04:46Z","timestamp":1633644286000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-03083-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3083"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-03083-y","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,6]]},"assertion":[{"value":"14 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"496"}}