Researchers from the UNC School of Medicine have discovered a connection between adenovirus infections and a rare blood clotting disorder, expanding knowledge on causes of severe thrombocytopenia. The findings, published in the New England Journal of Medicine, highlight the first known association between the respiratory virus and blood clotting.
Platelets, specialized cellular fragments responsible for forming blood clots during injuries, can experience a decline in count due to various conditions including viral infections and autoimmune diseases. Through extensive clinical and research collaboration, Dr. Stephan Moll and Dr. Jacquelyn Baskin-Miller identified the link between adenovirus infections and the development of a rare blood clotting disorder.
The newly observed disorder is one of four recognized anti-platelet factor 4 (PF4) disorders. Early diagnosis, appropriate treatment, and better outcomes are expected as a result of these findings. The discovery also prompts further research into understanding how and why this condition occurs, as well as identifying the individuals most at risk.
Anti-PF4 disorders involve the formation of antibodies against platelet factor-4 (PF4), leading to the activation and rapid removal of platelets in the bloodstream, causing blood clotting and low platelet count. This can occur as a result of heparin exposure or as a spontaneous autoimmune condition.
In recent years, rare cases of thrombocytopenia have been reported after injection with COVID-19 vaccines made with an adenoviral vector. This condition, known as vaccine-induced immune thrombotic thrombocytopenia (VITT), is distinct from the adenovirus-associated blood clotting disorder discovered in the current study.
The discovery originated from the case of a 5-year-old boy diagnosed with an adenovirus infection who developed cerebral sinus vein thrombosis and severe thrombocytopenia. Collaborative efforts between medical professionals led to the identification of the “spontaneous HIT” condition, triggered by adenoviral infection rather than heparin or vaccines.
Further collaboration with renowned researchers in the field confirmed the presence of anti-PF4 antibodies targeting platelet factor 4 in both the initial case and another patient with similar symptoms.
The findings pose new questions about the prevalence of this anti-PF4 disorder, its potential link to other viruses, and why it doesn’t occur in every adenovirus infection. Researchers also aim to determine preventative measures and optimized treatment approaches for patients affected by this potentially life-threatening disorder.
Dr. Moll emphasizes the need to understand the commonality of the disorder, the threshold for testing anti-PF4 antibodies, and the best strategies for treating patients to maximize their chance of survival.
The research deepens our understanding of the relationship between adenovirus infections and blood clotting disorders, providing new insights into their prevention, diagnosis, and treatment.