CTICasesThrombosis with Thrombocytopenia Syndrome
Imaging findings
CT angiography shows multiple venous thrombi including renal vein thrombosis and mesenteric venous thrombosis. Brain CT shows a massive hemorrhagic stroke with active arterial contrast extravasation. This occurred shortly after receiving an adenovirus-vector COVID-19 vaccine.
Key takeaways
Thrombosis with thrombocytopenia syndrome (TTS) is a rare, highly severe, immune-mediated adverse reaction associated with adenovirus-vector COVID-19 vaccines (e.g., AstraZeneca or Johnson & Johnson). It is characterized by high levels of anti-platelet factor 4 (PF4) antibodies causing simultaneous venous/arterial thrombosis and severe thrombocytopenia/hemorrhage.
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