Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study (2024)

Mahadevan, J. J., Psaltis, P. J., Thrift, A. G., & Kleinig, T. J. (2024). Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study. BMJ Neurology Open, 6(1), Article 000605. https://doi.org/10.1136/bmjno-2023-000605

Mahadevan, Joshua J. ; Psaltis, Peter J. ; Thrift, Amanda G. et al. / Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study. In: BMJ Neurology Open. 2024 ; Vol. 6, No. 1.

@article{8f6cbbc005484524864a4df46f0e797d,

title = "Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study",

abstract = "Objectives The identification of SARS-CoV-2 vaccineinduced immune thrombotic thrombocytopenia (VITT) followed the recognition of a hitherto uncommon clinical syndrome frequently associated with cerebral venous sinus thrombosis (CVST), termed 'thrombosis with thrombocytopenia' syndrome (TTS). While anecdotally recognised as rare, the background incidence of TTS is unknown. We therefore aimed to investigate the background incidence of CVST with TTS in a large, welldefined population-based CVST cohort. Methods We performed an analysis of our previously obtained retrospective population-based cohort of patients with CVST from Adelaide, Australia (2005-2011, comprising an adult population of 953 390) to identify the background incidence of CVST associated with TTS. Results Among 105 people with CVST, the background population-based incidence of TTS-associated CVST was 1.2 per million per year (95% CI 0.5 to 2.4). A single case of a severe CVST VITT-like syndrome with multiorgan thrombosis was identified, occurring 3 weeks postrotavirus infection. Conclusions In our population-based study, the background incidence of CVST with associated TTS was very low, and the sole clinically severe case with multiorgan thrombosis occurred following a rotaviral precipitant. Our study establishes a benchmark against which to measure future potential 'TTS' clusters and suggests that viruses other than adenovirus may trigger this syndrome.",

keywords = "CEREBROVASCULAR, CEREBROVASCULAR DISEASE, SINUS THROMBOSIS, STROKE",

author = "Mahadevan, {Joshua J.} and Psaltis, {Peter J.} and Thrift, {Amanda G.} and Kleinig, {Timothy J.}",

note = "Publisher Copyright: {\textcopyright} 2024 BMJ Publishing Group. All rights reserved.",

year = "2024",

month = may,

day = "15",

doi = "10.1136/bmjno-2023-000605",

language = "English",

volume = "6",

journal = "BMJ Neurology Open",

issn = "2632-6140",

publisher = "BMJ Publishing Group",

number = "1",

}

Mahadevan, JJ, Psaltis, PJ, Thrift, AG & Kleinig, TJ 2024, 'Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study', BMJ Neurology Open, vol. 6, no. 1, 000605. https://doi.org/10.1136/bmjno-2023-000605

Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study. / Mahadevan, Joshua J.; Psaltis, Peter J.; Thrift, Amanda G. et al.
In: BMJ Neurology Open, Vol. 6, No. 1, 000605, 15.05.2024.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study

AU - Mahadevan, Joshua J.

AU - Psaltis, Peter J.

AU - Thrift, Amanda G.

AU - Kleinig, Timothy J.

N1 - Publisher Copyright:© 2024 BMJ Publishing Group. All rights reserved.

PY - 2024/5/15

Y1 - 2024/5/15

N2 - Objectives The identification of SARS-CoV-2 vaccineinduced immune thrombotic thrombocytopenia (VITT) followed the recognition of a hitherto uncommon clinical syndrome frequently associated with cerebral venous sinus thrombosis (CVST), termed 'thrombosis with thrombocytopenia' syndrome (TTS). While anecdotally recognised as rare, the background incidence of TTS is unknown. We therefore aimed to investigate the background incidence of CVST with TTS in a large, welldefined population-based CVST cohort. Methods We performed an analysis of our previously obtained retrospective population-based cohort of patients with CVST from Adelaide, Australia (2005-2011, comprising an adult population of 953 390) to identify the background incidence of CVST associated with TTS. Results Among 105 people with CVST, the background population-based incidence of TTS-associated CVST was 1.2 per million per year (95% CI 0.5 to 2.4). A single case of a severe CVST VITT-like syndrome with multiorgan thrombosis was identified, occurring 3 weeks postrotavirus infection. Conclusions In our population-based study, the background incidence of CVST with associated TTS was very low, and the sole clinically severe case with multiorgan thrombosis occurred following a rotaviral precipitant. Our study establishes a benchmark against which to measure future potential 'TTS' clusters and suggests that viruses other than adenovirus may trigger this syndrome.

AB - Objectives The identification of SARS-CoV-2 vaccineinduced immune thrombotic thrombocytopenia (VITT) followed the recognition of a hitherto uncommon clinical syndrome frequently associated with cerebral venous sinus thrombosis (CVST), termed 'thrombosis with thrombocytopenia' syndrome (TTS). While anecdotally recognised as rare, the background incidence of TTS is unknown. We therefore aimed to investigate the background incidence of CVST with TTS in a large, welldefined population-based CVST cohort. Methods We performed an analysis of our previously obtained retrospective population-based cohort of patients with CVST from Adelaide, Australia (2005-2011, comprising an adult population of 953 390) to identify the background incidence of CVST associated with TTS. Results Among 105 people with CVST, the background population-based incidence of TTS-associated CVST was 1.2 per million per year (95% CI 0.5 to 2.4). A single case of a severe CVST VITT-like syndrome with multiorgan thrombosis was identified, occurring 3 weeks postrotavirus infection. Conclusions In our population-based study, the background incidence of CVST with associated TTS was very low, and the sole clinically severe case with multiorgan thrombosis occurred following a rotaviral precipitant. Our study establishes a benchmark against which to measure future potential 'TTS' clusters and suggests that viruses other than adenovirus may trigger this syndrome.

KW - CEREBROVASCULAR

KW - CEREBROVASCULAR DISEASE

KW - SINUS THROMBOSIS

KW - STROKE

UR - http://www.scopus.com/inward/record.url?scp=85193434564&partnerID=8YFLogxK

U2 - 10.1136/bmjno-2023-000605

DO - 10.1136/bmjno-2023-000605

M3 - Article

AN - SCOPUS:85193434564

SN - 2632-6140

VL - 6

JO - BMJ Neurology Open

JF - BMJ Neurology Open

IS - 1

M1 - 000605

ER -

Mahadevan JJ, Psaltis PJ, Thrift AG, Kleinig TJ. Incidence of thrombocytopenia-associated cerebral venous sinus thrombosis: a population-based study. BMJ Neurology Open. 2024 May 15;6(1):000605. doi: 10.1136/bmjno-2023-000605