Sex: M
Vaccine: COVID19
Symptoms: Blood fibrinogen, Blood thromboplastin, Deep vein thrombosis, Full blood count, International normalised ratio
Clinical narrative: Deep Venous Thrombosis; This spontaneous report was received from literature: Journal. This report concerned a 21 year old male. The objective of this study was Deep Venous Thrombosis after Ad26.COV2.S Vaccination in Adult Male.  The patient's height, and weight were not reported. The patient's pre-existing medical conditions included: no significant past medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported, 1 in Total administered for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported.  On initial evaluation, patient was noted to have mild erythema and edema of the left leg with circumferential diameter 40 centimeter comparative to 38 centimeter of the right leg. The patient was recommended to follow supportive care with conservative approach and discharged home. A day later, patient presented to the emergency department with worsening swelling of the left leg. On examination, left lower extremity edema was consistent with prior exam with new skin changes concerning for phlegmasia ceruleaolens. Lower extremity duplex showed absent blood flow in the left common femoral, profundal femoral, femoral, and calf veins due to occluding thrombus visualized from the iliac, femoral, popliteal to the left posterior tibial, and peroneal vein. Complete blood count including platelet count was normal. Coagulation panel included an elevated INR (international normalized ratio) at 14.3, PTT (Partial Thromboplastin Time) at 120 sec, and decreased fibrinogen at 172 mg/dl. Patient was noted to be negative for heparin-dependent platelet antibody (PF4) enzyme-linked immune sorbent assay (ELISA) IgA/M/G and serotonin release assay. Patient also received hypercoagulable workup for Factor V Leiden mutation, Prothrombin gene, serum homocysteine, anti-phospholipid antibody panel, antithrombin III activity, and protein C and S activity which were all unremarkable for underlying hypercoagulable etiology. The patient required left lower extremity venography with pharmacomechanical thrombolysis/thrombectomy with venous thrombolysis and placement of 16 millimeter by 100 millimeter left common iliac venous stent. Patient was maintained on direct thrombin inhibitor with argatroban, which was transitioned to oral apixaban upon discharge from the hospital. Venous duplex in one week is to be repeated. The patient was hospitalized on an unspecified date. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of deep venous thrombosis was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: V0:20211039977-COVID-19 VACCINE AD26.COV2.S-Deep venous thrombosis.  This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).