Thrombosis with thrombocytopenia syndrome (TTS) | Thrombocytopenia syndrome

What is TTS? ... The syndrome is characterised by thrombosis formation (blood clots) combined with thrombocytopenia (low platelet levels). It can be classified ...Thisinformationisaccurateasof23/8/2021.Pleasereferbacktothewebsitetoensureallreferenceinformationiscurrentandup-to-date.Thrombosiswiththrombocytopeniasyndrome(TTS)Thrombosiswiththrombocytopeniasyndrome (TTS),alsoknownas Vaccine-inducedprothromboticimmunethrombocytopenia (VIPIT)orvaccine-inducedimmunethromboticthrombocytopenia(VITT),isarareandnewlyidentifiedsyndromewhichhasbeenreportedinpeoplewhohavereceivedadenoviralvectorCOVID-19vaccinessuchas COVID-19AstraZeneca andtheJohnson&Johnson/JanssenCOVID-19vaccine.WhatisTTS?Thesyndromeischaracterisedbythrombosisformation(bloodclots)combinedwiththrombocytopenia(lowplateletlevels).Itcanbeclassifiedinto2tiersbasedonthelocationofthrombosisandseverityofsymptoms:Tier1:Uncommonsiteofthrombosis(egneurological–cerebralvenoussinusthrombosis[CVST]orgut–eg.splanchnicvein,associatedwithbowelischaemiaandsurgery,portalveinorotherrarevenousandarterialthromboses)Mayalsoconcurrentlyhavethrombosisinmorecommonlocations(e.gvenousthromboembolism,axillaryveinthrombosis,deepveinthrombosisorpulmonaryembolism)Plateletcount<150,000permicroliterPositive(+)heparin-P4ELISAHITantibodyresultissupportive,butnotrequiredfordiagnosisTier2:Commonsitesofthrombosissuchaslegorlungs(eg.venousthromboembolism,deepveinthrombosis,pulmonaryembolism)Plateletcount<150,000permicroliterPositive(+)heparin-P4ELISAHITantibodyresultisrequiredTier1ismoresevere,withhighermorbidityandmortalitythanTier2.EvidenceisemergingthatTier1ismorecommoninyoungeragegroups.HowdoadenoviralvectorvaccinestriggerTTS?TheexactmechanismofhowTTSistriggeredisstillunderinvestigation.Insomecases,anti-plateletfactor4(anti-PF4)antibodieshavebeenfound.TTSappearssimilartoanautoimmuneconditionknownasheparininducedthrombocytopenia(HIT),whereanimmunereactiontothemedicationheparinimpactsplateletfunction.WhatistheriskofTTS?CurrentAustraliandataestim

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