Researchers at McMaster University have made a groundbreaking discovery in hematology, revealing a new blood-clotting disorder that explains spontaneous and persistent clotting despite full-dose anticoagulation.
This condition, detailed in The New England Journal of Medicine on February 12, 2025, has significant implications for diagnosis and treatment.
The disorder, called VITT-like monoclonal gammopathy of thrombotic significance (MGTS), mimics vaccine-induced immune thrombocytopenia and thrombosis (VITT), previously linked to certain discontinued COVID-19 vaccines.
Patients develop blood-clotting due to antibodies that resemble VITT antibodies, even without heparin or prior vaccination.
Specialized testing revealed persistent VITT-like antibodies and monoclonal (M) proteins, pointing to a chronic pathological condition.
The study was led by Prof. Theodore Warkentin and included international collaborators from Canada, New Zealand, France, Spain, Germany, and Australia.
It analyzed patients with unexplained clotting despite anticoagulants and found that the VITT-like antibodies were linked to M proteins.
Collaborators confirmed these M proteins as the pathological agents using advanced testing.
Traditional blood thinners were ineffective in all patients. Benefits were seen with alternative therapies such as high-dose IVIG, Bruton tyrosine kinase inhibitors, and plasma cell-targeted therapies.
The discovery calls for new diagnostic approaches and treatments for recurrent or unexplained clotting disorders.
The research was supported by the Canadian Institutes of Health Research (CIHR), the Public Health Agency of Canada, and the Heart and Stroke Foundation of Canada.
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The study is published in New England Journal of Medicine.
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