LAUSR

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare but serious complication seen post COVID-19 vaccination, most notably in the UK after the Astra Zeneca vaccines, occurring in 1 per 50,000 vaccines in the under 50s and about 1 per 100,000 in the over 50s. VITT causes thromboses in both the arterial and venous beds, generally targeting unusual sites, with cerebral venous sinus thromboses accounting for 50% of the thromboses, and splanchnic vein thrombosis accounting for another 30%. Thrombosis is associated with thrombocytopenia, often a low fibrinogen and very high D-dimers. The syndrome has many similarities to heparin-induced thrombocytopenia and thrombosis and indeed the same antibody to Platelet Factor 4 is found in VITT and is considered to be the pathogenic cause. This is an immune response and therefore no identifying risk factors have been yet found other than younger age. The presentation and evolving management will be discussed.