akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2021.257akusherstvo-1098Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫVaccine-induced immune thrombotic thrombocytopenia: definition, risks with different vaccines, and regulatory responsesВакцин-индуцированная иммунная тромботическая тромбоцитопения: определение, риски при использовании разных вакцин и реакция регуляторных органовhttps://orcid.org/0000-0002-1388-5827АкиньшинаС. В.AkinshinaS. V.

Акиньшина Светлана Владимировна – кандидат медицинских наук, врач акушер-гинеколог, гематолог

109004 Москва, ул. Земляной Вал, д. 62

Svetlana V. Akinshina – MD, PhD, Obstetrician-Gynecologist, Hematologist

62 Str. Zemlyanoi Val, Moscow 109004

svetlana_akin@mail.ruhttps://orcid.org/0000-0001-8404-1042БицадзеВ. О.BitsadzeV. O.

Бицадзе Виктория Омаровна – доктор медицинских наук, профессор РАН, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 6506003478

Researcher ID: F-8409-2017

 

Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 6506003478

Researcher ID: F-8409-2017

 

https://orcid.org/0000-0002-0725-9686ХизроеваД. Х.KhizroevaJ. Kh.

Хизроева Джамиля Хизриевна – доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 57194547147

Researcher ID: F-8384-2017

 

Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 57194547147

Researcher ID: F-8384-2017

 

https://orcid.org/0000-0002-7756-8935ГригорьеваК. Н.GrigorievaK. N.

Григорьева Кристина Николаевна – ординатор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Kristina N. Grigoreva – MD, Medical Resident, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

https://orcid.org/0000-0001-7441-2778СлуханчукЕ. В.SlukhanchukE. V.

Слуханчук Екатерина Викторовна – кандидат медицинских наук, доцент кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); врач акушер-гинеколог отделения абдоминальной хирургии и онкологии 2 ФГБНУ «Российский научный центр хирургии имени академика Б.В. Петровского»

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

119991 Москва, Абрикосовский пер., д. 2

Ekaterina V. Slukhanchuk – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health; Obstetrician-Gynecologist, Department of Abdominal Surgery and Oncology 2

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

2 Abrikosovskiy Lane, Moscow 119991

https://orcid.org/0000-0002-3628-0804ТретьяковаМ. В.TretyakovaM. V.

Третьякова Мария Владимировна – кандидат медицинских наук, врач акушер-гинеколог отделения гинекологии

119021 Москва, ул. Тимура Фрунзе, д. 15/1

Maria V. Tretyakova – MD, PhD, Obstetrician-Gynecologist, Department of Gynecology

15/1 Timura Frunze Str., Moscow 119021

https://orcid.org/0000-0001-5888-0774ЦибизоваВ. И.TsibizovaV. I.

Цибизова Валентина Ивановна – акушер-гинеколог НИЛ оперативной гинекологии Института перинатологии и педиатрии; врач отделения функциональной и ультразвуковой диагностики

197341 Санкт-Петербург, ул. Аккуратова, д. 2

Valentina I. Tsibizova – MD, PhD, Obstetrician-Gynecologist, Research Laboratory of Operative Gynecology, Institute of Perinatology and Pediatrics; Physician, Department of Functional and Ultrasound Diagnostics

2 Akkuratova Str., Saint Petersburg 197341

https://orcid.org/0000-0002-9576-1368ЭлаламиИ.ElalamyI.

Элалами Исмаил – доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); профессор, Медицинский Университет Сорбонны; директор гематологии Центра Тромбозов, Госпиталь Тенон

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

75006 Париж, Улица медицинского факультета, д. 12;

75020 Париж, Китайская улица, д. 4

Scopus Author ID: 7003652413

Researcher ID: AAC-9695-2019

 

Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Medicine Sorbonne University, Paris, France; Director of Hematology, Department of Thrombosis Center, Hospital Tenon

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

2 Rue de l’École de Médecine, 75006 Paris;

4 Rue de la Chine, 75020 Paris

Scopus Author ID: 7003652413

Researcher ID: AAC-9695-2019

 

https://orcid.org/0000-0002-9899-9910ГриЖ.-К.GrisJ.-C.

Гри Жан-Кристоф – доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); профессор гематологии, Университет Монпелье

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

34090 Монпелье, ул. Огюста Бруссоне, д. 163

Researcher ID: AAA-2923-2019

 

Jean-Christophe Gris – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University, Moscow, Russia; University of Montpellier

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

163 Rue Auguste Broussonnet, Montpellier 34090

Researcher ID: AAA-2923-2019

БреннерБ.BrennerB.

Бреннер Биньямин – доктор медицинских наук, профессор, директор Института гематологии и трансплантации костного мозга; директор отдела внутренних болезней

31096 Хайфа, ул. Алия-а-Шния, д. 8

Binyamin Brenner – MD, Dr Sci Med, Professor, Director of the Hematology and Bone Marrow Transplantation Institute; Director of the Department of Internal Medicine

31096 Haifa, Aliya-ha-Shniya Str., 8

https://orcid.org/0000-0002-8980-9783ГрандонеЭ.GrandoneE.

Грандоне Эльвира – доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); профессор, руководитель отделения тромбозов и гемостаза, Исследовательский центр «Casa Sollievo della Sofferenza»

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

1013 Сан-Джованни-Ротондо, Viale Cappuccini, д. 1

Scopus Author ID: 7006391091

Researcher ID: M-1127-2019

 

Elvira Grandone – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Thrombosis and Haemostasis Research Unit, Department of Medical Genetics, Ospedale "Casa Sollievo della Sofferenza"

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

1 Viale Cappuccini, San Giovanni Rotondo 71013

Scopus Author ID: 7006391091. Researcher ID: M-1127-2019.

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia;

1 Viale Cappuccini, San Giovanni Rotondo 71013, Italia

https://orcid.org/0000-0003-2607-9717АйЦ.AyC.

Aй Цихан – доктор медицинских наук, профессор, клиническое подразделение гематологии и гемостазиологии, медицинское отделение I

1010 Вена, Universitätsring, д. 1

Scopus Author ID: 55356863800

Cihan Ay – MD, PhD, Professor, Department of Medicine I, Clinical Division of Haematology and  Haemostaseology

1 Universitätsring, Vienna 1010

Scopus Author ID: 55356863800

https://orcid.org/0000-0001-7415-4633МакацарияА. Д.MakatsariyaA. D.

Макацария Александр Давидович – доктор медицинских наук, профессор, академик РАН, зав. кафедрой акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 57222220144

Researcher ID: M-5660-2016

 

Alexander D. Makatsariya – MD, Dr Sci Med, Academician of RAS, Professor, Head of the Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 57222220144

Researcher ID: M-5660-2016

 

ООО «Медицинский женский центр»Россия«Medical Centre for Women» LLCRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); ФГБНУ «Российский научный центр хирургии имени академика Б.В. Петровского»РоссияSechenov University; Petrovsky National Research Centre of SurgeryRussian FederationООО «Лечебный Центр»Россия«Medical Center» LLCRussian FederationФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research Centre, Health Ministry of Russian FederationRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Медицинский Университет Сорбонны; Госпиталь ТенонФранцияSechenov University; Medicine Sorbonne University; Hospital TenonFranceФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Университет МонпельеФранцияSechenov University; University of MontpellierFranceАкадемический госпиталь РамбамИзраильRambam Academic HospitalIsraelФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Исследовательский центр «Casa Sollievo della Sofferenza»ИталияSechenov University; Research Center «Casa Sollievo della Sofferenza»ItalyВенский университетАвстрияUniversity of ViennaAustria202107102021155562575Copyright © Akinshina S.V., Bitsadze V.O., Khizroeva J.K., Grigorieva K.N., Slukhanchuk E.V., Tretyakova M.V., Tsibizova V.I., Elalamy I., Gris J., Brenner B., Grandone E., Ay C., Makatsariya A.D., 20212021Акиньшина С.В., Бицадзе В.О., Хизроева Д.Х., Григорьева К.Н., Слуханчук Е.В., Третьякова М.В., Цибизова В.И., Элалами И., Гри Ж., Бреннер Б., Грандоне Э., Ай Ц., Макацария А.Д.Akinshina S.V., Bitsadze V.O., Khizroeva J.K., Grigorieva K.N., Slukhanchuk E.V., Tretyakova M.V., Tsibizova V.I., Elalamy I., Gris J., Brenner B., Grandone E., Ay C., Makatsariya A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1098

After the vaccination campaign initiation in Europe and the UK, reports of rare cases of atypical thrombosis, including sinus vein thrombosis and splanchnic venous thrombosis, began to appear in association with the use of vector vaccines AstraZeneca (ChAdOx1) and Johnson & Johnson/Janssen. The syndrome called VITT (vaccine-induced immune thrombotic thrombocytopenia) manifested as thrombosis simultaneously with a decrease in platelet count, a significant increase in D-dimer levels and a detection of factor 4 platelet (PF4) antibodies. We present a detailed review of the epidemiology, pathogenesis, clinical presentation, diagnostics and treatment of VITT, which is by its nature an immune complication, similar to the processes occurring in heparin-induced thrombocytopenia (HIT). All international and national organizations and regulatory authorities, including experts in the field of thrombosis and hemostasis and the VITT expert council recommend continuing the prompt mass vaccination against COVID-19 as the only method that can reduce the incidence of severe cases, stop the spread of COVID-19 infection and the emergence of new dangerous mutations in the viral genome. Failure to vaccinate poses an incomparably greater risk of fatal thrombotic and inflammatory complications associated with infections, compared with the risks of extremely rare adverse events that can occur after vaccination. It should be noted that information on VITT, described as a sporadic phenomenon of an abnormal immune response to some variants of vaccines against COVID-19, cannot be translated to other vaccines (including registered in the Russian Federation) and even more cannot be a reason for refusal to use them.

После запуска массовой вакцинации в Европе и Великобритании стали появляться сообщения о редких случаях тромбозов атипичных локализаций, включая тромбозы синусов головного мозга и висцеральных вен, связанных с применением аденовирусных векторных вакцин AstraZeneca (ChAdOx1) и Johnson & Johnson/Janssen. Синдром, который получил название VITT (англ. vaccine induced immune thrombotic thrombocytopenia) – вакцин-индуцированная иммунная тромботическая тромбоцитопения, сопровождается снижением количества тромбоцитов, значительным повышением уровня Д-димера и выявлением антител к тромбоцитарному фактору 4 (англ. platelet factor 4, PF4). В статье представлен детальный обзор вопросов эпидемиологии, рассмотрены клинические симптомы, патогенез, методы диагностики и лечения VIТT, которая по своей природе является иммунным осложнением, подобным гепарин-индуцированной тромбоцитопении (ГИТ). В настоящее время все международные и национальные регуляторные организации, сообщества гематологов, включая специальную экспертную комиссию по VITT, рекомендуют продолжение скорейшей массовой вакцинации против СOVID-19 как единственного метода, который способен снизить частоту тяжелых случаев инфекции, остановить ее распространение и появление новых опасных мутаций в вирусном геноме. Отказ от вакцинации грозит несравнимо большим риском смертельных тромботических и воспалительных осложнений, связанных с инфекций, по сравнению с рисками крайне редких нежелательных явлений, которые могут возникнуть после вакцинации. Информация по VITT, описанной в качестве крайне редко возникающего феномена аномальной иммунной реакции на некоторые варианты вакцин против СOVID-19, не может транслироваться на другие вакцины (в частности, одобренные в Российской Федерации) и тем более не может быть причиной для отказа в их использовании.

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The authors declare that there are no conflicts of interest present.