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The man presented with abdominal pain, diarrhoea and vomiting. He had received first dose of AZD-1222 [chAdOx1 nCoV-19 vaccine; AstraZeneca; route and dosage not stated] vaccine 13 days prior for prevention of COVID-19. Scanning electron microscopy (SEM) examination showed dilated, irregular shape and collapsed alveoli, thickened interalveolar septa, a reticular network of fibrin in alveolar, tremendous proliferation of small capillaries led to plexiform structures, pulmonary capillary hemangiomatosis-like features and completely modified architecture of large areas of the pulmonary parenchyma. Additionally, near the alveoli occupied by a dense fibrin network, the medium-sized arteries showed a modified wall and an intraluminal thrombus. Based on the examinations, he was diagnosed with AZD-1222-induced immune thrombotic thrombocytopenia.

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A 58-year-old man developed immune thrombotic thrombocytopenia following AZD-1222 vaccination for prevention of COVID-19.

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