Bengaluru, NFAPost: Researchers at the University of North Carolina (UNC) have uncovered a significant connection between adenovirus infection and a rare blood clotting disorder. Stephan Moll, MD, and Jacquelyn Baskin-Miller, MD, from the UNC School of Medicine, have identified a correlation between the common respiratory virus, which typically causes mild cold and flu symptoms, and severe thrombocytopenia accompanied by blood clots.
Their groundbreaking findings, detailed in the New England Journal of Medicine, shed light on a previously uncharted area of research and present a new facet of understanding regarding the virus and its impact on platelet factor 4 (PF4) disorders. The identified disorder becomes the fourth anti-PF4 disorder to be recognized.
Anti-PF4 disorders involve the immune system generating antibodies against platelet factor-4 (PF4), a protein released by platelets. The formation of these antibodies can lead to platelet activation, resulting in the rapid removal of platelets from the bloodstream, subsequently causing blood clotting and low platelet levels. Such disorders can be triggered by heparin exposure, leading to heparin-induced thrombocytopenia (HIT), or can manifest as an autoimmune condition without heparin exposure, referred to as “spontaneous HIT.”
In recent years, there have been instances of thrombocytopenia occurring after the administration of COVID-19 vaccines using an adenoviral vector, termed vaccine-induced immune thrombotic thrombocytopenia (VITT). This new UNC discovery adds another layer of complexity to the understanding of anti-PF4 disorders, as it showcases the link between adenovirus infection and a similar thrombotic and platelet-depleting condition.
The journey to this revelation began with the case of a 5-year-old boy who displayed aggressive cerebral sinus vein thrombosis (a blood clot forming in the brain) along with severe thrombocytopenia. While the classical triggers of HIT and VITT were ruled out, this case led to collaborative efforts between intensive care physicians, neuro-intensivists, and the haematology group. Dr. Baskin-Miller’s outreach to Dr. Moll initiated a comprehensive clinical exploration, ultimately determining the presence of “spontaneous HIT” antibodies.
Further collaboration with Theodore E. Warkentin, MD, an esteemed anti-PF4 disorders researcher, confirmed that the antibodies targeted platelet factor 4 in a manner akin to HIT antibodies. This conclusion marked a significant step in understanding the correlation between adenovirus infection and this unique blood clotting disorder.
However, this discovery also raises numerous unanswered questions, including the prevalence of this new anti-PF4 disorder, the potential role of other viruses in causing similar conditions, and the reasons behind the selective manifestation of this disorder in cases of adenovirus infection. The researchers are now keen to explore preventive and treatment strategies for patients affected by this condition, which can potentially lead to life-threatening consequences.
As the scientific community continues to grapple with these newly unearthed connections, Moll and his team strive to gather a more comprehensive understanding of the disorder’s scope, diagnosis thresholds, and effective treatment methodologies, aiming to enhance the prospects of survival for those impacted by this potentially lethal ailment.
