Anti‐<scp>PF4</scp> mediated thrombocytopenia and thrombosis associated with acute cytomegalovirus infection displays both <scp>HIT</scp>‐like and <scp>VITT</scp>‐like characteristics
Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is one of several anti-platelet factor 4 (anti-PF4)-associated immune thrombocytopenia and thrombosis (PITT) syndromes. As well as following adenoviral vector vaccines, VITT has recently been described following acute adenovirus infection. We describe a patient with PITT following acute cytomegalovirus infection. The antibody clonotype and PF4 epitopes were distinct from those identified in VITT, and they were detectable as a paraprotein. PITT should be considered in all patients with thrombocytopenia and thrombosis, even without preceding vaccination or heparin, but who otherwise meet the VITT criteria defined by the British Society of Haematology Expert Panel.
Authors
- Will Lester (ORCID: https://orcid.org/0000-0001-8790-7112)
- Samantha J. Montague (ORCID: https://orcid.org/0000-0002-8934-3901)
- Jeffrey P. Sharman
- Phillip L.R. Nicolson (ORCID: https://orcid.org/0000-0002-4843-2975)
- Eman Hassan (ORCID: https://orcid.org/0000-0002-0696-6848)
- Dhruv Parekh (ORCID: https://orcid.org/0000-0002-1508-8362)
- Richard J. Buka (ORCID: https://orcid.org/0000-0002-2738-6236)
- Anthony Calvert (ORCID: https://orcid.org/0009-0008-9359-2282)
- Phillip El‐Dalil
- Jo‐Ann I. Sheppard (ORCID: https://orcid.org/0000-0002-4402-7809)
- Tom P. Gordon (ORCID: https://orcid.org/0000-0003-3232-8249)
- J. Harrison
- Ishac Nazy (ORCID: https://orcid.org/0000-0002-5695-4343)
- Theodore E. Warkentin (ORCID: https://orcid.org/0000-0002-8046-7588)
- Yi Zhang (ORCID: https://orcid.org/0000-0001-9861-4681)
- Jing Jing Wang (ORCID: https://orcid.org/0000-0003-0114-5570)
- Husam Osman
- Errin Lawrence
Institutions
- South Australia Pathology (AU)
- NHS Blood and Transplant (GB)
- Flinders University (AU)
- Queen Elizabeth Hospital Birmingham (GB)
- Flinders Medical Centre (AU)
- Heartlands Hospital (GB)
- Hamilton Health Sciences (CA)
- University of Birmingham (GB)
- McMaster University (CA)
Publication Details
- Journal
- British Journal of Haematology
- Published
- 2025-04-29
- DOI
- https://doi.org/10.1111/bjh.20092
- Citations
- 9
- Primary Topic
- Heparin-Induced Thrombocytopenia and Thrombosis
- Type
- article
- Field-Weighted Citation Impact
- 18.06
Funders
- Heart and Stroke Foundation of Canada
- Public Health Agency of Canada
- National Institute for Health and Care Research
- British Heart Foundation
- Public Health Agency
- Canadian Institutes of Health Research