key: cord-0728181-wx4vzsp1 authors: Karnam, Anupama; Lacroix‐Desmazes, Sébastien; Kaveri, Srini V.; Bayry, Jagadeesh title: Vaccine‐induced immune thrombotic thrombocytopenia: Consider IVIG batch in the treatment date: 2021-06-27 journal: J Thromb Haemost DOI: 10.1111/jth.15361 sha: b8b506288936ec1551b8206bbcd629d3a385d67b doc_id: 728181 cord_uid: wx4vzsp1 Various vaccines have been developed recently to protect the population from corona virus disease-19 (COVID-19). Although the beneficial effects of vaccines outweigh the risks associated with vaccination, an unusual but life threatening thrombosis and thrombocytopenia has been observed in certain individuals who received recombinant adenoviral vector encoding spike protein of SARS-CoV-2 ChAdOx1 nCov-19 (AstraZeneca)1-4 . Exploration of underlying mechanisms have identified that ChAdOx1 nCov-19 vaccine-induced platelet-activating antibodies against platelet factor 4 (PF4) are responsible for these adverse events1-3 . Based on the in vitro experimental evidence that showed therapeutic potential of intravenous immunoglobulin (IVIG), a pooled normal IgG, in preventing the platelet activation by anti-PF4 antibodies, and also founded on the initial experience with IVIG-treatment in these patients1,2 , a recent report by Thaler et al. demonstrated a successful treatment of a vaccine-induced prothrombotic immune thrombocytopenic patient with high dose IVIG therapy5 . The authors have no competing interests to declare. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector-based COVID-19 vaccine Successful treatment of vaccineinduced prothrombotic immune thrombocytopenia (VIPIT) IVIG-mediated effector functions in autoimmune and inflammatory diseases Does intravenous immunoglobulin therapy in Guillain-Barré syndrome patients interfere with serological Zika detection? Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey No SARS-CoV-2 neutralization by intravenous immunoglobulins produced from plasma collected before the 2020 pandemic Rapidly increasing SARS-CoV-2 neutralization by intravenous immunoglobulins produced from plasma collected during the 2020 pandemic