Anti-PF4 mediated thrombocytopenia and thrombosis associated with acute cytomegalovirus infection displays both HIT-like and VITT-like characteristics
Nicolson, Phillip L R Montague, Samantha J Buka, Richard J Calvert, Anthony Sheppard, Jo-Ann I Zhang, Yi Wang, Jing Jing Sharman, Jack Hassan, Eman Harrison, James
Nicolson, Phillip L R
Montague, Samantha J
Buka, Richard J
Calvert, Anthony
Sheppard, Jo-Ann I
Zhang, Yi
Wang, Jing Jing
Sharman, Jack
Hassan, Eman
Harrison, James
Abstract
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.
Date
2025-04-29
Type
Article
Subject
Cytomegalovirus infections, Heparin, Antibodies, monoclonal, Thrombocytopaenia, Thrombosis
Collections
Citation
Nicolson PLR, Montague SJ, Buka RJ, Calvert A, Sheppard JI, Zhang Y, Wang JJ, Sharman J, Hassan E, Harrison J, Lawrence E, El-Dalil P, Parekh D, Osman H, Gordon TP, Nazy I, Warkentin TE, Lester WA. Anti-PF4 mediated thrombocytopenia and thrombosis associated with acute cytomegalovirus infection displays both HIT-like and VITT-like characteristics. Br J Haematol. 2025 Jun;206(6):1737-1742. doi: 10.1111/bjh.20092. Epub 2025 Apr 29.
Journal / Source Title
British Journal of Haematology
DOI
10.1111/bjh.20092
PMID
40298004
Publisher
Wiley-Blackwell
Publisher’s URL
https://onlinelibrary.wiley.com/journal/13652141