«Autoimmune thrombocytopenia is a much less serious disease than Vitt (vaccine-induced immune thrombotic thrombocytopenia) and has negligible mortality in young people. It also does not represent a known risk factor for rare thrombosis associated with viral vector vaccines. ‘ The hematologist Pier Mannuccio Mannucci, Emeritus Professor of Internal Medicine at the University of Milan and member of the Aifa (Italian Medicines Agency) commission for the evaluation of the thrombosis risk associated with the anti Covid vaccination, comments on the news relating to Camilla Canepa, the 18-year-old who died on 10 June at the San Martino hospital in Genoa due to a very serious cerebral thrombosis and consequent haemorrhage. On May 25, Camilla was vaccinated in Genoa, taking advantage of an “open day”, and had received the first dose of AstraZeneca.
Professor, why is autoimmune thrombocytopenia (Itp) different from “vaccine-induced immune thrombotic thrombocytopenia”?
“Autoimmune thrombocytopenia is generally not accompanied by thrombotic events and the antibodies that are formed are directed against the surface proteins of platelets. The latter, damaged, are eliminated by the spleen. This leads to platelet deficiency. The precise mechanism that triggers Vitt is not yet known, but it certainly includes a process of autoimmunity, ie the production of autoantibodies against the fourth platelet factor and the creation of a “polyanion”. Factor 4 is a positively charged substance, ie a cation, and there is a negatively charged substance, an anion, which binds to platelet factor 4; then autoantibodies are produced which bind to platelets, activate them and trigger hypercoagulability. At the same time the autoantibodies cause the platelets to be consumed, hence thrombocytopenia. This is a well known process, what is not yet clear is what is this polyanion which looks like heparin but is not heparin. It is a negatively charged substance that, according to some hypotheses, could be produced with viral vector vaccines. The mechanism of Itp and Vitt is similar, but the antibodies and antigens are different ».
Can autoimmune thrombocytopenia be cured?
«Absolutely yes – explains Mannucci -. We know that autoimmunity is more frequent in young women and the incidence of Vitt confirms this feature. Autoimmune diseases have two peaks, one in youth (especially among women) and the second in old age after 70. The latter data is not observed in the case of rare post vaccine thrombosis, although some cases in elderly subjects have been reported in France “.
Could the platelet deficiency have worsened the cerebral hemorrhage following the thrombosis in Camilla’s case?
«If the girl had autoimmune thrombocytopenia, that is, not cured or perfectly compensated by the therapy, she could have worsened the bleeding. This hypothesis cannot be ruled out at the moment ».
What could have happened at the Genoa “open day” where Camilla received the first dose of the AstraZeneca vaccine?
“In itself, neither autoimmune thrombocytopenia nor hormone therapy (Camilla was taking double hormone therapy, ed) represent specific risk factors for the Vitt. The main risk factor for this girl was age. We now know that there is a link between viral vector vaccines and rare thrombosis cases, especially in young women. Furthermore, since we have known this cause-effect relationship, vaccinators have avoided proposing AstraZeneca or Janssen to people with pathologies, preferring Pfizer and Moderna, even if it is an empirical prudence, not supported by scientific data. So it amazes me that Camilla received this vaccine. I am not against open days, they can be useful for example for the elderly who do not know how to handle the computer. But I don’t think they should be open to everyone ». Investigators investigating the girl’s death are verifying whether or not the vaccinator was informed of the girl’s health condition, either verbally or via the medical history.
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June 11, 2021 (change June 11, 2021 | 15:32)
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