Therapeutic plasma exchange and intravenous immune globulin in the treatment of heparin‐induced thrombocytopenia: A systematic review

Transfusion ◽  
2020 ◽  
Vol 60 (11) ◽  
pp. 2714-2736 ◽  
Author(s):  
Chinonso Onuoha ◽  
Karen D. Barton ◽  
Edward C.C. Wong ◽  
Jay S. Raval ◽  
Marian A. Rollins‐Raval ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasma Exchange ◽  
Immune Globulin ◽  
Therapeutic Plasma Exchange ◽  
Intravenous Immune Globulin ◽  
Heparin Induced Thrombocytopenia

Intravenous immune globulin and thromboembolic adverse events: A systematic review and meta-analysis of RCTs

2016 ◽  
Vol 91 (6) ◽  
pp. 594-605 ◽  
Author(s):  
Eric M. Ammann ◽  
Cole B. Haskins ◽  
Kelsey M. Fillman ◽  
Rebecca L. Ritter ◽  
Xiaomei Gu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Immune Globulin ◽  
Meta Analysis ◽  
Intravenous Immune Globulin

scholarly journals Refractory vaccine-induced thrombotic thrombocytopenia (VITT) managed with delayed therapeutic plasma exchange (TPE)

2021 ◽  
Author(s):  
Ajay Major ◽  
Timothy Carll ◽  
Clarence W. Chan ◽  
Chancey Christenson ◽  
Geoffrey D. Wool ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Alcoholic Cirrhosis ◽  
Therapeutic Plasma Exchange ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
Platelet Factor ◽  
Heparin Induced Thrombocytopenia ◽  
Sustained Improvement ◽  
Vein Thrombosis ◽  
Hematologic Disorder

Abstract Vaccine-induced thrombotic thrombocytopenia (VITT) is a newly-described hematologic disorder which presents as acute thrombocytopenia and thrombosis after administration of adenovirus-based vaccines against COVID-19. Due to positive assays for antibodies against platelet factor 4 (PF4), VITT is managed similarly to autoimmune heparin-induced thrombocytopenia (HIT) with intravenous immunoglobulin (IVIG) and non-heparinoid anticoagulation. We describe a case of VITT in a 50-year-old man with antecedent alcoholic cirrhosis who presented with platelets of 7 × 103/µL and portal vein thrombosis 21 days following administration of the Ad26.COV2.S COVID-19 vaccine. The patient developed progressive thrombosis and persistent severe thrombocytopenia despite IVIG, rituximab and high-dose steroids and had persistent anti-PF4 antibodies over 30 days after his initial presentation. As such, delayed therapeutic plasma exchange (TPE) was pursued as salvage therapy, with a rapid and sustained improvement in his platelet count. Our case serves as proof-of-concept of the efficacy of TPE in VITT.

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