![]() ![]() TTS appears similar to an autoimmune condition known as heparin induced thrombocytopenia (HIT), where an immune reaction to the medication heparin impacts platelet function, leading to thrombosis. Currently there are no clear diagnostic markers to indicate who is at risk of this syndrome. The exact mechanism of how TTS is triggered is still under investigation, however the majority of cases are associated with the finding of anti-PF4 antibodies. How do adenoviral vector vaccines trigger TTS? Evidence is emerging that Tier 1 is more common in younger age groups. Tier 1 tends to be associated with more severe presentations, and carries a higher risk of morbidity and mortality than Tier 2. positive (+) heparin-P4 ELISA HIT antibody result is required.venous thromboembolism, deep vein thrombosis, pulmonary embolism) common sites of thrombosis such as leg or lungs (eg.positive (+) heparin-P4 ELISA HIT antibody result is supportive, but not required for diagnosis.platelet count ![]() may also concurrently have thrombosis in more common locations (e.g deep vein thrombosis or pulmonary embolism).splanchnic vein, associated with bowel ischaemia and surgery, portal vein or other rare venous and arterial thromboses) uncommon site of thrombosis (eg brain – cerebral venous sinus thrombosis or gut – eg.Cases are further classified based on if there has been recent exposure to heparin or not. TTS can be classified into 2 tiers based on the location of thrombosis and severity of symptoms. The syndrome is characterised by thrombosis formation (blood clots) combined with thrombocytopenia (low platelet count). Thrombosis with thrombocytopenia syndrome (TTS), also known as Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) or vaccine-induced immune thrombotic thrombocytopenia (VITT), is a rare and newly identified syndrome which has been reported in people who have received adenoviral vector COVID-19 vaccines such as Vaxzevria (AstraZeneca) and the Johnson & Johnson/Janssen COVID-19 vaccine. ![]()
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January 2023
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