Haematuria, a widespread petechial rash, and headaches following the Oxford AstraZeneca ChAdOx1 nCoV-19 Vaccination

BMJ Case Rep. 2021 Oct 7;14(10):e245440. doi: 10.1136/bcr-2021-245440.


With increasing presentations of headaches following COVID-19 vaccination, we present one of the UK's earliest proven cases of vaccine-induced thrombotic thrombocytopaenia (VITT), with the aim of giving colleagues a case to compare other patients against. Our patient was a 48-year-old man who presented with frank haematuria, a widespread petechial rash, and headaches, 2 weeks after receiving the first dose of the Oxford AstraZeneca ChAdOx1 nCoV-19 vaccine. He had a platelet count of 14×109/L and an extensive cerebral venous sinus thrombosis (CVST) with subarachnoid haemorrhage on imaging. He developed localising neurological signs and experienced a cardiopulmonary arrest. He was successfully resuscitated and transferred to a tertiary care centre for urgent thrombectomy. This case illustrates how the diagnosis of VITT should be based on the platelet count and imaging-and how patients with VITT should be cared for in centres with urgent neurosurgical and interventional radiology services.

Keywords: COVID-19; emergency medicine; general practice / family medicine; haematology (incl blood transfusion); public health.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19
  • Exanthema*
  • Headache
  • Hematuria
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Sinus Thrombosis, Intracranial*
  • Vaccination


  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19