{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:12Z","timestamp":1760145552850,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Thrombosis after severe acute respiratory syndrome coronavirus 2 vaccination is a serious complication in patients with a thrombophilic predisposition. Herein, we present a 17-year-old female who had underlying antiphospholipid syndrome (APS) and developed deep vein thrombosis (DVT) 6 months after her second BNT162b2 vaccine dose. Although she had no family history of thrombosis, she had previously developed DVT at 6 years of age, with thrombus formation in the right common iliac vein and the inferior vena cava, along with concomitant left pulmonary infarction. The patient had received anticoagulant therapy for 6 years after DVT onset, with subsequent treatment cessation for 5 years without recurrence. She received the BNT162b2 vaccine at 17 years of age, 1 week before a routine outpatient visit. Platelet factor 4 elevation was detected 14 days after the first vaccination, persisting for 5 months without thrombotic symptoms. Six months after the second vaccine dose, the DVT recurred and was treated with a direct oral anticoagulant. The vaccine was hypothesized to exacerbate the patient\u2019s APS by activating coagulation. Platelet factor 4 levels may indicate coagulation status. When patients predisposed to thrombosis are vaccinated, coagulation status and platelet activation markers should be monitored to prevent DVT development.<\/jats:p>","DOI":"10.3390\/hematolrep16030048","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T18:04:59Z","timestamp":1722535499000},"page":"504-511","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Persistently High Platelet Factor 4 Levels in an Adolescent with Recurrent Late Thrombotic Complications after SARS-CoV-2 mRNA Vaccination"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0816-7695","authenticated-orcid":false,"given":"Yoichi","family":"Haga","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5317-347X","authenticated-orcid":false,"given":"Akira","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuneyoshi","family":"Yakuwa","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akari","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Midori","family":"Udo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ohara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yasumoto","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Blood Transfusion, Hokkaido University Hospital, North-14, West-5, Kita-ku, Sapporo-shi 060-8648, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Medical Center Omori Hospital, 6-11-1, Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"ref_1","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. 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