Therapeutic Plasma Exchange in Vaccine-Induced Immune Thrombotic Thrombocytopenia

This letter describes three cases of refractory vaccine-induced immune thrombotic thrombocytopenia (VITT) following ChAdOx1 nCoV-19 vaccination. Despite initial treatment with non-heparin anticoagulation and IVIG, patients had persistent thrombocytopenia and progressive thrombosis. Therapeutic plasma exchange (TPE) was initiated, leading to clinical improvement in two patients and prevention of further thrombosis in the third. The authors suggest TPE as a potential intervention for VITT unresponsive to standard therapy, though further validation is needed.

This letter describes three cases of refractory vaccine-induced immune thrombotic thrombocytopenia (VITT) following ChAdOx1 nCoV-19 vaccination. Despite initial treatment with non-heparin anticoagulation and IVIG, patients had persistent thrombocytopenia and progressive thrombosis. Therapeutic plasma exchange (TPE) was initiated, leading to clinical improvement in two patients and prevention of further thrombosis in the third. The authors suggest TPE as a potential intervention for VITT unresponsive to standard therapy, though further validation is needed.