A case of Vaccine-Induced Thrombotic Thrombocytopenia (VITT) with thrombosis of the superior mesenteric artery after ChAdOx1 nCov-19 COVID-19 Vaccine

We describe the case of a 64 years-old woman admitted to Emergency Department ASST-Spedali Civili Brescia with fever and gastrointestinal symptoms 10 days after first dose ChAdOx1 nCov-19 vaccine. Laboratory investigations showed severe thrombocytopenia high D-dimer, while an abdominal CT scan reported partially occluding thrombosis superior mesenteric artery. Following treatment fondaparinux, immunoglobulins dosage steroid therapy, we observed rapid improvement patient’s conditions. An ELISA assay presence antibodies against heparin PF4-complex. Subsequent CT-scan artery resolution, patient was finally discharged 12 hospitalization. Several reports pointed venous system as main district affected by Vaccine-Induced Thrombotic Thrombocytopenia (VITT), peculiar feature this report is involvement arterial system. Further investigation VITT’s pathophysiological mechanisms mandatory develop preventive strategies effective treatments.