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  1. Article ; Online: Post-lumbar puncture cerebral vein thrombosis.

    Marasco, Vincenzo / Gianniello, Francesca / Paolucci, Aldo / Martinelli, Ida / Capecchi, Marco

    EJHaem

    2023  Volume 5, Issue 1, Page(s) 222–224

    Abstract: Lumbar puncture (LP) is rarely complicated by cerebral vein thrombosis (CVT), especially if other risk factors coexist. We describe the case of a 28-year-old woman who developed CVT after corticosteroid treatment and LP performed for suspected multiple ... ...

    Abstract Lumbar puncture (LP) is rarely complicated by cerebral vein thrombosis (CVT), especially if other risk factors coexist. We describe the case of a 28-year-old woman who developed CVT after corticosteroid treatment and LP performed for suspected multiple sclerosis. The day after LP, she developed intense headache and on Day 8 generalized tonic-clonic seizures. A brain computed tomography scan showed thrombosis of the superior sagittal sinus and cortical veins. Thrombophilia screening showed heterozygous G20210A prothrombin mutation. Anticoagulant therapy with low molecular weight heparin and then warfarin was administered until Day 16 after LP, when a brain magnetic resonance imaging showed a subdural hematoma. Warfarin was interrupted and dabigatran was started. The patient recovered completely, both from the initial thrombotic event and the hemorrhagic complication. This case highlights the importance to keep in mind CVT in the differential diagnosis of post-LP headache not responsive to standard therapy, and suggests that dabigatran can be considered an effective and safe treatment of CVT.
    Language English
    Publishing date 2023-11-13
    Publishing country United States
    Document type Case Reports
    ISSN 2688-6146
    ISSN (online) 2688-6146
    DOI 10.1002/jha2.803
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Diagnosis and Management of the Antiphospholipid Syndrome.

    Ciavarella, Alessandro / Martinelli, Ida

    The New England journal of medicine

    2018  Volume 379, Issue 13, Page(s) 1289

    MeSH term(s) Antibodies, Antiphospholipid ; Antiphospholipid Syndrome ; Humans
    Chemical Substances Antibodies, Antiphospholipid
    Language English
    Publishing date 2018-09-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc1808253
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  3. Article ; Online: Where do we stand with antithrombotic prophylaxis in patients with COVID-19?

    Ciavarella, Alessandro / Peyvandi, Flora / Martinelli, Ida

    Thrombosis research

    2020  Volume 191, Page(s) 29

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Critical Illness ; Fibrinolytic Agents ; Humans ; Incidence ; Intensive Care Units ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Chemical Substances Fibrinolytic Agents
    Keywords covid19
    Language English
    Publishing date 2020-04-20
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2020.04.023
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  4. Article ; Online: Comparison of adverse drug reactions among four COVID-19 vaccines in Europe using the EudraVigilance database: Thrombosis at unusual sites.

    Abbattista, Maria / Martinelli, Ida / Peyvandi, Flora

    Journal of thrombosis and haemostasis : JTH

    2021  Volume 19, Issue 10, Page(s) 2554–2558

    Abstract: Background: Real-world experience with adenoviral vector vaccines against COVID-19 raised some safety concerns. Cases of cerebral vein thrombosis (CVT) associated with thrombocytopenia have been observed after the first dose of the adenoviral vector ... ...

    Abstract Background: Real-world experience with adenoviral vector vaccines against COVID-19 raised some safety concerns. Cases of cerebral vein thrombosis (CVT) associated with thrombocytopenia have been observed after the first dose of the adenoviral vector vaccines CHADOX1 NCOV-19 and AD26.COV2.S.
    Objectives: To assess the reporting rate of CVT as adverse drug reaction (ADR) for the COVID-19 vaccines authorized in Europe.
    Patients and methods: This observational study assessed the CVT reporting rate attributed to four COVID-19 vaccines authorized in Europe, namely Tozinameran (Pfizer-Biontech), CX-024414 (Moderna), CHADOX1 NCOV-19 (AstraZeneca), and AD26.COV2.S (Janssen). Data on thrombotic ADRs reported on EudraVigilance database between January 1, 2021 and July 30, 2021, were collected. ADRs referring to CVT were identified. The reporting rate of CVT was expressed as 1 million individual vaccinated-days with 95% confidence interval. Finally, an observed-to-expected (OE) analysis was performed.
    Results: The reporting rate of CVT per 1 million person vaccinated-days was 1.92 (95% confidence interval [CI], 1.71-2.12) for Tozinameran, 5.63 (95% CI, 4.74-6.64) for CX-024414, 21.60 (95% CI, 20.16-23.11) for CHADOX1 NCOV-19, and 11.48 (95% CI, 9.57-13.67) for AD26.COV2.S. CVT occurred alongside thrombocytopenia for the four vaccines. The OE ratio was greater than one for all four vaccines, both with the lowest and the highest CVT background incidence.
    Conclusions: This report on EudraVigilance data strengthens anecdotal findings on CVT following COVID-19 vaccinations. Although the European Medicines Agency released an alert only for CHADOX1 NCOV-19 and AD26.COV2.S, Tozinameran and CX-024414 also are complicated by CVT, albeit to lesser extent.
    MeSH term(s) COVID-19 ; COVID-19 Vaccines ; ChAdOx1 nCoV-19 ; Drug-Related Side Effects and Adverse Reactions ; Europe ; Humans ; SARS-CoV-2 ; Thrombosis ; Vaccines
    Chemical Substances COVID-19 Vaccines ; Vaccines ; ChAdOx1 nCoV-19 (B5S3K2V0G8)
    Language English
    Publishing date 2021-08-25
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15493
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    Zs.MO 295: Show issues

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  5. Article ; Online: Cerebral vein thrombosis.

    Martinelli, Ida

    Thrombosis research

    2013  Volume 131 Suppl 1, Page(s) S51–4

    Abstract: The estimated annual incidence of cerebral vein thrombosis (CVT) is 3 to 4 cases per million in adults and 7 cases per million in neonates. Among the commonest risk factors there are oral contraceptive use, pregnancy and puerperium that make CVT more ... ...

    Abstract The estimated annual incidence of cerebral vein thrombosis (CVT) is 3 to 4 cases per million in adults and 7 cases per million in neonates. Among the commonest risk factors there are oral contraceptive use, pregnancy and puerperium that make CVT more frequent in women than in men. Cerebral tumors, infections and traumas are less encountered local risk factors. In 15-20% of patients CVT remains unprovoked. Coagulation abnormalities causing thrombophilia, as well as hyperhomocysteinemia, are worthy to be investigated in patients with CVT. Rarely CVT can be the first clinical manifestation of a myeloproliferative neoplasm. The recurrence rate of CVT is low, but venous thromboembolism in the common sites (lower-limb deep vein thrombosis or pulmonary embolism) can recur, particularly in patients with a first idiopathic CVT. Early diagnosis and anticoagulant treatment reduce morbidity of CVT and improve survival, although the optimal duration of anticoagulant treatment is not well established.
    MeSH term(s) Adult ; Anticoagulants/therapeutic use ; Cerebral Veins/physiopathology ; Female ; Humans ; Intracranial Thrombosis/diagnosis ; Intracranial Thrombosis/physiopathology ; Intracranial Thrombosis/therapy ; Male ; Mutation ; Pregnancy ; Pregnancy Complications, Hematologic/diagnosis ; Prognosis ; Recurrence ; Risk Factors ; Thromboembolism ; Treatment Outcome
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2013-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/S0049-3848(13)70022-7
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  6. Article ; Online: Genetic Variants Identified by Whole Exome Sequencing in a Large Italian Family with High Plasma Levels of Factor VIII and Von Willebrand Factor.

    Spena, Silvia / Cairo, Andrea / Gianniello, Francesca / Pappalardo, Emanuela / Mortarino, Mimosa / Garagiola, Isabella / Martinelli, Ida / Peyvandi, Flora

    International journal of molecular sciences

    2023  Volume 24, Issue 18

    Abstract: High plasma levels of factor VIII (FVIII) and von Willebrand factor (VWF) have been indicated as independent risk factors for venous thromboembolism. However, the genetic factors responsible for their increase remain poorly known. In a large Italian ... ...

    Abstract High plasma levels of factor VIII (FVIII) and von Willebrand factor (VWF) have been indicated as independent risk factors for venous thromboembolism. However, the genetic factors responsible for their increase remain poorly known. In a large Italian family with high FVIII/VWF levels and thrombotic episodes, whole exome sequencing (WES) was performed on 12 family members to identify variants/genes involved in FVIII/VWF increase. Twenty variants spread over a 8300 Kb region on chromosome 5 were identified in 12 genes, including the low frequency rs13158382, located upstream of the
    Language English
    Publishing date 2023-09-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms241814167
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  7. Article ; Online: Treatment of unusual thrombotic manifestations.

    Abbattista, Maria / Capecchi, Marco / Martinelli, Ida

    Blood

    2020  Volume 135, Issue 5, Page(s) 326–334

    Abstract: Venous thrombosis rarely occurs at unusual sites such as cerebral, splanchnic, upper-extremity, renal, ovarian, or retinal veins. Clinical features, symptoms, and risk factors of rare thrombotic manifestations are heterogeneous and in large part differ ... ...

    Abstract Venous thrombosis rarely occurs at unusual sites such as cerebral, splanchnic, upper-extremity, renal, ovarian, or retinal veins. Clinical features, symptoms, and risk factors of rare thrombotic manifestations are heterogeneous and in large part differ from those typical of the commonest manifestations of venous thrombosis at the lower extremities. The therapeutic approach also varies widely according to the affected site, whether cerebral, abdominal, or extraabdominal. To date, anticoagulant therapy for thrombosis at unusual sites is generally accepted, but the optimal therapeutic approach remains challenging. This review is focused on the treatment of unusual thrombotic manifestations as reported in the most recent guidelines and according to the updated scientific literature.
    MeSH term(s) Anticoagulants/therapeutic use ; Early Detection of Cancer ; Humans ; Thrombophilia/diagnosis ; Thrombosis/drug therapy
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2020-01-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2019000918
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  8. Article: Thrombotic Complications in Patients with Immune-Mediated Hemolysis.

    Capecchi, Marco / Ciavarella, Alessandro / Artoni, Andrea / Abbattista, Maria / Martinelli, Ida

    Journal of clinical medicine

    2021  Volume 10, Issue 8

    Abstract: Autoimmune hemolytic anemias are rare and heterogeneous disorders characterized by hemolysis, which is a well-recognized risk factor for thrombosis. The most common immune-mediated anemias are represented by autoimmune hemolytic anemia and paroxysmal ... ...

    Abstract Autoimmune hemolytic anemias are rare and heterogeneous disorders characterized by hemolysis, which is a well-recognized risk factor for thrombosis. The most common immune-mediated anemias are represented by autoimmune hemolytic anemia and paroxysmal nocturnal hemoglobinuria, both associated with a high rate of thrombosis. Multiple pathophysiological mechanisms for thrombosis have been proposed, involving hemolysis itself and additional effects of the immune system. Despite the increasing awareness of the thrombotic risk in these conditions, evidence-based guidance on prevention and management of thrombotic events is lacking. We herein report available evidence on epidemiological data on thrombosis and thrombophilia in immune-mediated hemolysis, together with possible underlying pathophysiological mechanisms. In addition, we summarize current recommendations for treatment of thrombosis in immune-mediated hemolysis. In particular, we address the issue of thrombotic complications treatment and prophylaxis by proposing a therapeutic algorithm, focusing on specific situations such as splenectomy and pregnancy.
    Language English
    Publishing date 2021-04-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10081764
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  9. Article: Anticoagulant Therapy in Patients with Antiphospholipid Syndrome.

    Capecchi, Marco / Abbattista, Maria / Ciavarella, Alessandro / Uhr, Mario / Novembrino, Cristina / Martinelli, Ida

    Journal of clinical medicine

    2022  Volume 11, Issue 23

    Abstract: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by the persistent positivity of antiphospholipid antibodies (aPLA) together with thrombosis or obstetrical complications. Despite their recognized predominant role, aPLA are ... ...

    Abstract Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by the persistent positivity of antiphospholipid antibodies (aPLA) together with thrombosis or obstetrical complications. Despite their recognized predominant role, aPLA are not sufficient to induce the development of thrombosis and a second hit has been proposed to be necessary. The mainstay of treatment of APS is anticoagulant therapy. However, its optimal intensity in different presentations of the disease remains undefined. Moreover, decision on which patients with aPLA would benefit from an antithrombotic prophylaxis and its optimal intensity are challenging because of the lack of stratification tools for the risk of thrombosis. Finally, decision on the optimal type of anticoagulant drug is also complex because the central pathway responsible for the development of thrombosis is so far unknown and should be carried out on an individual basis after a careful evaluation of the clinical and laboratory features of the patient. This review addresses the epidemiology, physiopathology, diagnosis and management of thrombosis and obstetrical complications in APS, with a special focus on the role of direct oral anticoagulants.
    Language English
    Publishing date 2022-11-26
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11236984
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  10. Article ; Online: Direct oral anticoagulants for the treatment of cerebral vein thrombosis.

    Capecchi, Marco / Abbattista, Maria / De Simone, Pantaleo / Artoni, Andrea / Gianniello, Francesca / Bucciarelli, Paolo / Paolucci, Aldo / Martinelli, Ida

    Thrombosis research

    2022  Volume 220, Page(s) 153–155

    MeSH term(s) Humans ; Cerebral Veins ; Intracranial Thrombosis/drug therapy ; Anticoagulants/therapeutic use ; Thrombosis
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-11-05
    Publishing country United States
    Document type Letter
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2022.11.001
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