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<p>Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but serious complication of adenoviral vector COVID-19 vaccines, characterized by thrombosis, thrombocytopenia, and elevated D‑dimer. In this descriptive study (June–November 2021), 19 patients with suspected VITT were evaluated at a tertiary hematology lab in northern India. Anti‑PF4 antibodies were screened using a gel card immunoassay, with confirmation by platelet activation test (PAT; &gt;20% aggregation defined positive).Ten patients (mean age 38.1 years; M:F 1:4) met clinical VITT criteria (thrombosis 4–42 days post‑ChAdOx1 vaccination, thrombocytopenia, elevated D‑dimer). Gel card was strongly positive in five, borderline in two, and negative in three. PAT confirmed VITT in eight patients, including three with negative/borderline immunoassay results. All PAT‑positive cases showed heparin‑independent platelet activation. Functional platelet testing is essential for VITT diagnosis, as immunoassay alone may miss 20% of cases. An integrated diagnostic approach—combining clinical criteria, D‑dimer, immunoassay, and confirmatory functional assay—is recommended for accurate VITT detection.</p>

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Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) – Experience Of The Only Hospital In India Carrying Out Platelet Activation Test (Functional Assay)

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Surbhi Dahiya,
  • Jyoti Kotwal,
  • Lovely K Titus,
  • Sabina Langer Kumar,
  • Amrita Saraf,
  • Pallavi Prakhar

摘要

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but serious complication of adenoviral vector COVID-19 vaccines, characterized by thrombosis, thrombocytopenia, and elevated D‑dimer. In this descriptive study (June–November 2021), 19 patients with suspected VITT were evaluated at a tertiary hematology lab in northern India. Anti‑PF4 antibodies were screened using a gel card immunoassay, with confirmation by platelet activation test (PAT; >20% aggregation defined positive).Ten patients (mean age 38.1 years; M:F 1:4) met clinical VITT criteria (thrombosis 4–42 days post‑ChAdOx1 vaccination, thrombocytopenia, elevated D‑dimer). Gel card was strongly positive in five, borderline in two, and negative in three. PAT confirmed VITT in eight patients, including three with negative/borderline immunoassay results. All PAT‑positive cases showed heparin‑independent platelet activation. Functional platelet testing is essential for VITT diagnosis, as immunoassay alone may miss 20% of cases. An integrated diagnostic approach—combining clinical criteria, D‑dimer, immunoassay, and confirmatory functional assay—is recommended for accurate VITT detection.