A5090314016- Atrial Fibrillation Management and Outcomes
- Heparin-Induced Thrombocytopenia and Thrombosis
- Venous Thromboembolism Diagnosis and Management
- Platelet Disorders and Treatments
- Blood Coagulation and Thrombosis Mechanisms
- Blood disorders and treatments
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Intramuscular injections and effects
- Hemophilia Treatment and Research
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Acute Myocardial Infarction Research
- Vasculitis and related conditions
- Complement system in diseases
- Clinical Laboratory Practices and Quality Control
- Lanthanide and Transition Metal Complexes
- Peripheral Neuropathies and Disorders
- Erythrocyte Function and Pathophysiology
- Hematological disorders and diagnostics
- Blood groups and transfusion
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
- Advanced MRI Techniques and Applications
- Cerebral Venous Sinus Thrombosis
- Cardiac Valve Diseases and Treatments
- Cardiac, Anesthesia and Surgical Outcomes
- Atomic and Subatomic Physics Research
Oslo University Hospital
2017-2025
Akershus University Hospital
2017-2024
University of Oslo
2017-2021
We report findings in five patients who presented with venous thrombosis and thrombocytopenia 7 to 10 days after receiving the first dose of ChAdOx1 nCoV-19 adenoviral vector vaccine against coronavirus disease 2019 (Covid-19). The were health care workers 32 54 years age. All had high levels antibodies platelet factor 4-polyanion complexes; however, they no previous exposure heparin. Because cases occurred a population more than 130,000 vaccinated persons, we propose that represent rare...
Abstract Aims We recently reported five cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) 7–10 days after receiving the first dose ChAdOx1 nCoV-19 adenoviral vector vaccine against corona virus disease 2019 (COVID-19). aimed to investigate pathogenic immunological responses operating in these patients. Methods and results assessed circulating inflammatory markers by assays cell phenotyping flow cytometry analyses performed immunoprecipitation with anti-platelet factor (PF)4...
During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was rapid severe progression disease in spite maximum treatment efforts, resulting fatal outcome for 4 out 5 patients. All had received ChAdOx1 nCov-19 vaccine 1–2 weeks earlier developed characteristic syndrome thereafter. The progressive course high fatality rate CVT thrombocytopenia such cluster...
ObjectivesThe use of unopposed oral anticoagulants while undergoing cardiothoracic surgery is associated with severe bleeding and increased morbidity. The aim this experimental study was to examine if the apixaban concentration in reconstituted blood could be reduced an vitro setup by CytoSorb whole adsorber, how affected global coagulation assays.Design SettingAn performed a laboratory.ParticipantsAn blood.InterventionsReconstituted spiked circulated circuit 300 mL device...
An increasing number of patients are treated with direct-acting oral anticoagulants (DOACs), but the optimal way to reverse anticoagulant effect is not known. Specific antidotes available and prothrombin complex concentrate (PCC), activated PCC (aPCC) recombinant factor VIIa (rFVIIa) variously used as reversal agents in case a major bleeding. We aimed determine most effective haemostatic agent dose rivaroxaban blood samples from taking for therapeutic reasons.Blood rivaroxaban-treated (n =...
Emicizumab is a nonfactor replacement therapy for hemophilia A (HA) and bispecific monoclonal antibody mimicking factor VIII by binding both factors IXa X. Although it reduces the frequency of bleeding episodes, there still need bypassing agents in case breakthrough bleeds or surgery. The HAVEN-1 study showed an increased risk thrombotic events episodes microangiopathic hemolytic anemia with simultaneous treatment emicizumab activated prothrombin complex concentrate (aPCC) high doses (>100...
ChAdOx1 nCoV-19 vaccination has been associated with the rare side effect; vaccine-induced immune thrombotic thrombocytopenia (VITT). The mechanism of thrombosis in VITT is high levels neutrophil extracellular traps (NETs). present study examines whether key markers for NETosis, such as H3-NETs and calprotectin, well syndecan-1 endotheliopathy, can be used prognostic factors to predict severity complications vaccination. Five patients VITT, 10 prolonged symptoms cutaneous hemorrhages but...
The lack of an antidote against factor Xa inhibitors in case major bleeding or need for urgent surgery is a concern to clinicians. Guidelines on managing patients under anticoagulation with inhibitor suggest several hemostatic agents reverse the effect, but there no consensus regarding choice drug appropriate dose. ability prothrombin complex concentrate, activated and recombinant VIIa effect has been evaluated animal studies, vitro healthy volunteers, not yet randomized clinical studies. We...
Essentials•An antidote for apixaban is not yet available.•We tested the effect of different haemostatic agents to reverse in vitro.•Activated prothrombin complex concentrate (aPCC) was superior and recombinant activated factor VII.•Even low doses aPCC reversed completely vitro.ACKNOWLEDGMENTSWe acknowledge statistical assistance from Richard Lee. The anti‐Xa assays were performed at Department Medical Biochemistry Oslo University Hospital.Funding: study financially supported by an...
1 IntroductionSevere COVID‐19 is associated with an important increase of von Willebrand factor and mild lowering ADAMTS13 activity that may, in the presence a strong inflammatory reaction, risk acute thrombotic thrombocytopenic purpura (TTP). Although episodes immune‐mediated TTP or SARS‐CoV‐2 vaccination have been reported, data about clinical evolution hereditary (hTTP) during pandemic are scarce.2 MethodWe conducted survey among adult patients International Hereditary Registry...
Factor Xa inhibitors are safe and effective alternatives to warfarin, but several studies indicate that rivaroxaban may cause a different risk profile for bleeding. For instance, while the of major bleeding in general be lower with than gastrointestinal or abnormal uterine higher. The underlying mechanisms these differences not known, effect on primary hemostasis is poorly understood. aim this study was investigate platelet function, P-selectin von Willebrand factor (VWF) antigen activity....
Hemolytic interference may impact various laboratory tests, including coagulation analyses. Apixaban is the most commonly used direct oral anticoagulant in Norway, and there lacking knowledge on how apixaban concentration measurements might be influenced by hemolysis. Moreover, hemolysis-induced alterations levels could potentially risk of bleeding specific clinical scenarios. We wanted to study whether hemolysis would increase investigate hemolytic measurements.
Increased levels of neutrophil extracellular traps (NETs) have been detected in individuals with vaccine complications after the ChAdOx1 nCov a correlation between severity side effects and level NETosis. DNases may disrupt NETs by degrading their content DNA, balance has reported DNases. Because this since inflammatory marker be used as confirmatory test diagnosing VITT, it is interest to monitor DNase patients increased levels. The current novel rapid ELISA was tested blood samples known...
Factor (F) Xa inhibitors are safe and effective alternatives to warfarin. There concerns about the lack of a reversal strategy in case serious bleeds or need for emergency surgery situations when antidote andexanet alfa is not available. concentrates widely used, but there few clinical studies regarding effect activated prothrombin complex concentrate (aPCC). Because feared thrombogenicity, administration lowest dose would be desirable. To determine concentration aPCC sufficient reverse...
Nina Haagenrud Schultz er spesialist i blodsykdommer og overlege ved Avdeling for