Evidence map›Paper›PMID 40298004›Full record

ArticleBritish journal of haematology2025

Anti-PF4 mediated thrombocytopenia and thrombosis associated with acute cytomegalovirus infection displays both HIT-like and VITT-like characteristics.

Phillip L R Nicolson, Samantha J Montague, Richard J Buka, Anthony Calvert, Jo-Ann I Sheppard, Yi Zhang, Jing Jing Wang, Jack Sharman, Eman Hassan, James Harrison and 8 more

Abstract readCase Reports
In one paragraph

Article in British journal of haematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Classification of Platelet-Activating Anti-Platelet Factor 4 Disorders.International journal of laboratory hematology · 2026
    Review
  2. Adenoviral Inciting Antigen and Somatic Hypermutation in VITT.The New England journal of medicine · 2026
    Observational
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Phillip L R NicolsonDepartment of Haemostasis, Liaison and Transfusion Haematology, Queen Elizabeth Hospital, Birmingham, UK.ORCID https://orcid.org/0000-0002-4843-2975
Samantha J MontagueDepartment of Cardiovascular Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Richard J BukaDepartment of Cardiovascular Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Anthony CalvertH&I, NHS Blood and Transplant, Bristol, UK.
Jo-Ann I SheppardDepartment of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Yi ZhangMcMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada.
Jing Jing WangDepartment of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Jack SharmanDepartment of Critical Care, Queen Elizabeth Hospital, Birmingham, UK.
Eman HassanDepartment of Haemostasis, Liaison and Transfusion Haematology, Queen Elizabeth Hospital, Birmingham, UK.ORCID https://orcid.org/0000-0002-0696-6848
James HarrisonDepartment of Critical Care, Queen Elizabeth Hospital, Birmingham, UK.
Errin LawrenceDepartment of Critical Care, Queen Elizabeth Hospital, Birmingham, UK.
Phillip El-DalilDepartment of Critical Care, Queen Elizabeth Hospital, Birmingham, UK.
Dhruv ParekhDepartment of Critical Care, Queen Elizabeth Hospital, Birmingham, UK.
Husam OsmanDepartment of Virology, Birmingham Heartlands Hospital, Birmingham, UK.
Tom P GordonDepartment of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
Ishac NazyMcMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada.
Theodore E WarkentinDepartment of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Will A LesterDepartment of Haemostasis, Liaison and Transfusion Haematology, Queen Elizabeth Hospital, Birmingham, UK.ORCID https://orcid.org/0000-0001-8790-7112

Funding

British Heart Foundation AA/18/2/34218British Heart Foundation PG/23/11230CIHR 363046Flinders Health and Medical Research InstituteHeart and Stroke Foundation of Canada G-23-0035035National Institute for Health and Care Research (NIHR) Biomedical Research Centre NIHR203326The Public Health Agency of CanadaUniversity of Birmingham Department of Cardiovascular Sciences
6 · The paper itself

Abstract

Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is one of several anti-platelet factor 4 (anti-PF4)-associated immune thrombocytopenia and thrombosis (PITT) syndromes. As well as following adenoviral vector vaccines, VITT has recently been described following acute adenovirus infection. We describe a patient with PITT following acute cytomegalovirus infection. The antibody clonotype and PF4 epitopes were distinct from those identified in VITT, and they were detectable as a paraprotein. PITT should be considered in all patients with thrombocytopenia and thrombosis, even without preceding vaccination or heparin, but who otherwise meet the VITT criteria defined by the British Society of Haematology Expert Panel.

Indexed as

AutoantibodiesCytomegalovirus InfectionsPlatelet Factor 4ThrombocytopeniaThrombosisAcute DiseaseHumansAutoantibodiesPF4 protein, humanPlatelet Factor 4cytomegalovirusFCY receptorheparin‐induced TPmonoclonal antibodiesplatelet activationplatelet factor 4thrombocytopeniathrombosis

Identifiers

PMID40298004
PMCPMC12166337

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.