TABLE 1.
Blood tests during the admission of a 60‐year‐old woman with ischemic stroke and immune‐mediated thrombocytopenia following vaccination
| Day 1 | Day 2a | Day 3 | Day 6 | Reference range | |
|---|---|---|---|---|---|
| C‐reactive protein (mg/L) | 2.6 | 188 | 235 | 67 | <8.0 |
| Pro‐calcitonin (μg/L) | 0.33 | 0.17 | <0.5 | ||
| White‐cell count (per μl) | 11,100 | 8500 | 6700 | 5800 | 3500–10,000 |
| Neutrophil count (per μl) | 9500 | 6220 | 4940 | 3960 | 2000–7000 |
| Lymphocyte count (per μl) | 860 | 1560 | 1130 | 900 | 1300–3500 |
| Monocyte count (per μl) | 630 | 600 | 470 | 680 | 200–700 |
| Eosinophil count (per μl) | 10 | 110 | 100 | 0 | <500 |
| Hemoglobin (g/dl) | 14.0 | 13.7 | 13.5 | 8.4 | 11.8–15.3 |
| Haptoglobin (mg/dl) | 160 | 50–210 | |||
| Sodium (mmol/L) | 138 | 133 | 135 | 159 | 137–145 |
| Potassium (mmol/L) | 3.1 | 3.5 | 3.7 | 4 | 3.5–4.6 |
| Lactic acid (mg/dl) | 18.02 | 5.40 | 5.40 | 6.31 | 4.5–22.5 |
| Creatinine (mg/dl) | 0.77 | 1.14 | 1.0 | 1.04 | 0.51–1.02 |
| INR | 1.0 | 1.1 | 1.2 | 1.1 | <1.2 |
| APTT (s) | 28 | 32 | 27 | 22–38 | |
| Platelet count (per μl) | 118,000 | 50,000 | 24,000 | 5000 | 165,000–400,000 |
| D‐dimer (ng FEU/ml) | 41,800 | 97,800 | 106,200 | <500 | |
| Factor V Leiden mutation | Heterozygous | ||||
| Antithrombin (IU/ml) | 0.70 | 0.67 | 0.9 | 0.80–1.20 | |
| Fibrinogen (mg/dl) | 374 | 269 | 231 | 170–374 | |
| Thromboelastometry (ROTEM) | |||||
| EXTEM CT (sec)b | 84 | <74 | |||
| EXTEM A10 (mm)b | 46 | >48 | |||
| FIBTEM A10 (mm)b | 14 | >8 | |||
| INTEM CT (sec)b | 144 | <121 | |||
| Protein C activity (IU/ml) | 0.70 | 0.70–1.40 | |||
| Protein S, free antigen | 0.68 | 0.55–1.20 | |||
| Antiphospholipid antibodiesc | Negative | ||||
| Blood smear description | No definite schistocytes |
||||
| Immunoglobulins IgA/IgM/IgG | Normal | ||||
| Complement C3c/C4 | Normal | ||||
| Cryoglobulins | Not present | ||||
| Antineutrophilic antibodies | 0 | <1 | |||
| ADAMTS13 | Normal | ||||
| Platelet antibodiesd | Not present |
To convert values for hemoglobin to millimoles per liter multiply by 0.6202, lactic acid to millimoles per liter multiply by 0.1110, creatinine to micromoles per liter multiply by 88.4, and fibrinogen to micromoles per liter multiply by 0.0294.
Abbreviations: ADAMTS13, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13; APTT, activated partial thromboplastin time; FEU, fibrinogen‐equivalent units; INR, international normalized ratio; ROTEM, rotational thromboelastometry.
The blood sample on day 2 was sampled 1–2 h after stroke onset, and additional tests (D‐dimer, fibrinogen, antithrombin) 7 h after the first sample. Platelet count 8 h before stroke onset was 55,000 per μl.
EXTEM CT: extrinsic pathway (tissue factor) clotting time. EXTEM A10: amplitude of formed clot 10 min after formation. FIBTEM A10: fibrin‐dependent clot formation, amplitude of the formed clot at 10 min. INTEM CT: intrinsic pathway clotting time.
Lupus anticoagulant, and beta‐2‐glycoprotein 1 and cardiolipin antibodies.
Antibodies against GP‐IIb/IIIa, GP‐Ia/IIa, GP‐Ib/IX, and GP‐IV.