Search

COVID-19 vaccine remains critical to control the severe acute respiratory syndrome coronavirus 2 (SARS CoV 2), early recognition and management for COVID-19 vaccine associated side effects are imperative for physicians. COVID-19 vaccine-induced thrombosis with thrombocytopenia syndrome (TTS) is one of potential life-threating complication. The pathophysiology of TTS is presumably the development of antibodies against platelet factor 4 (PF4), further resulting in platelet consumption, depletion, and thrombus formation. COVID-19 vaccine-induced TTS has been reported as a very rare complication after the ChAdOx1 nCoV-19 (AstraZeneca) vaccination and usually manifesting as cerebral venous thrombosis or pulmonary artery embolism. Comparison with stroke and pulmonary embolism, TTS associated intra-abdominal thrombosis is less common. We report a rare case of abdominal pain after the first-dose ChAdOx1 COVID-19 (AstraZeneca) vaccination, the final diagnosis is TTS complicated by hepatic vein thrombosis. Early diagnosis and timely management strategies for TTS are required.

Diabetes mellitus is the major cause of retinopathy, nephropathy and neuropathy. Hyperglycemia is one of major major advised effect on diabetes mellitus. Hemichorea-hemiballism, a rare manifestation of nonketotic hyperglycemia, characterized by involuntary arrhythmic motions in one side of the body which results from focal lesions in the contralateral basal ganglia. Here, we present a 39-year-old woman with violent involuntary rapid and irregular movements of left limbs three days prior to emergency department. Nonketotic hyperglycemia related hemichorea-hemiballism had been confirmed by biochemistry examination and brain computed tomography (CT). Aggressive glucose control with insulin was administered. Her symptoms got improvement gradually after euglycemia two weeks later.