Trombocytopeni er en tilstand hvor kroppen har for lavt antall blodplater. Konsekvensen er blødninger, tidvis svært alvorlige tilstander. Det finnes ulike årsaker – en av de er covidvaksinering.

Trombocytopeni og kompliserende kombinasjonstilstander

I tilslutning til mRNA vaksinene er autoimmune forhold hyppigst omtalt i relasjon til trombocytopeni. Fordi disse vaksinene forårsaker en rekke bivirkninger fra blodkarsystemet – som vaskulitt, blodpropp, arytmi og myokarditt – blir kombinasjonen av symptomer ofte fatal og svært komplisert å behandle.

Bivirkninger: Abnorme blodpropper etter Covidvaksinering: 150 studier

Bivirkninger: Myokarditt & Covidvaksinering: 228 studier

Alvorlige menstruasjonsblødninger

Trombocytopeni vil også øke blødningstendens som et forsterkende forhold hos kvinner med menstruasjonsforstyrrelser relatert til covidvaksinering. Dette er kvinner som gjerne har blitt kompensert med noen få hundrelapper i bleieutgifter fra staten. I de alvorligeste tilfellene har man måtte fjerne livmoren hos unge, fertile kvinner for å unngå dødelig utfall.

116 fagfellevurderte studier

De 116 fagfellevurderte forskningsrapportene som presenteres angående trombocytopeni relatert til mRNA/Covidvaksinering er hentet fra Dr. Mark Trozzis nettside:

1. Vaccine-induced immune thrombotic thrombocytopenia with disseminated intravascular coagulation and death after ChAdOx1 nCoV-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34171649/
2. US case reports of cerebral venous sinus thrombosis with thrombocytopenia after vaccination with Ad26.COV2.S (against covid-19), March 2 to April 21, 2020: https://pubmed.ncbi.nlm.nih.gov/33929487/
3. Management of cerebral and splanchnic vein thrombosis associated with thrombocytopenia in subjects previously vaccinated with Vaxzevria (AstraZeneca): position statement of the Italian Society for the Study of Hemostasis and Thrombosis (SISET): https://pubmed.ncbi.nlm.nih.gov/33871350/
4. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis after vaccination with COVID-19; a systematic review: https://www.sciencedirect.com/science/article/pii/S0022510X21003014
5. Thrombosis with thrombocytopenia syndrome associated with COVID-19 vaccines: https://www.sciencedirect.com/science/article/abs/pii/S0735675721004381
6. Covid-19 vaccine-induced thrombosis and thrombocytopenia: a commentary on an important and practical clinical dilemma: https://www.sciencedirect.com/science/article/abs/pii/S0033062021000505

7. Thrombosis with thrombocytopenia syndrome associated with COVID-19 viral vector vaccines: https://www.sciencedirect.com/science/article/abs/pii/S0953620521001904
8. COVID-19 vaccine-induced immune-immune thrombotic thrombocytopenia: an emerging cause of splanchnic vein thrombosis: https://www.sciencedirect.com/science/article/pii/S1665268121000557
9. The roles of platelets in COVID-19-associated coagulopathy and vaccine-induced immune thrombotic immune thrombocytopenia (covid): https://www.sciencedirect.com/science/article/pii/S1050173821000967

10. Thrombotic immune thrombocytopenia induced by SARS-CoV-2 vaccine: https://www.nejm.org/doi/full/10.1056/nejme2106315
11. Thrombosis and thrombocytopenia after vaccination with ChAdOx1 nCoV-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2104882?query=recirc_curatedRelated_article

12. Post-mortemfindings in vaccine-induced thrombotic thrombocytopenia (covid-19): https://haematologica.org/article/view/haematol.2021.279075
13. Thrombocytopenia, including immune thrombocytopenia after receiving COVID-19 mRNA vaccines reported to the Vaccine Adverse Event Reporting System (VAERS): https://www.sciencedirect.com/science/article/pii/S0264410X21005247

14. Hypothesis behind the very rare cases of thrombosis with thrombocytopenia syndrome after SARS-CoV-2 vaccination: https://www.sciencedirect.com/science/article/abs/pii/S0049384821003315
15. Primary adrenal insuficiency associated with thrombotic immune thrombocytopenia induced by the Oxford-AstraZeneca ChAdOx1 nCoV-19 vaccine (VITT): https://www.sciencedirect.com/science/article/pii/S0953620521002363
16. Early results of bivalirudin treatment for thrombotic thrombocytopenia and cerebral venous sinus thrombosis after vaccination with Ad26.COV2.S: https://www.sciencedirect.com/science/article/pii/S0196064421003425
17. Mechanisms of immunothrombosis in vaccine-induced thrombotic thrombocytopenia (VITT) compared to natural SARS-CoV-2 infection: https://www.sciencedirect.com/science/article/abs/pii/S0896841121000706
18. Vaccine-induced thrombotic thrombocytopenia: the dark chapter of a success story: https://www.sciencedirect.com/science/article/pii/S2589936821000256
19. Cerebral venous sinus thrombosis and thrombocytopenia after COVID-19 vaccination: report of two cases in the United Kingdom: https://www.sciencedirect.com/science/article/abs/pii/S088915912100163X
20. Immune thrombocytopenic purpura after vaccination with COVID-19 vaccine (ChAdOx1 nCov-19): https://www.sciencedirect.com/science/article/abs/pii/S0006497121013963.
21. Vaccine-induced thrombotic thrombocytopenia, a rare but severe case of friendlyfire in the battle against the COVID-19 pandemic: What pathogenesis?: https://www.sciencedirect.com/science/article/pii/S0953620521002314

22. Thrombocytopenia and intracranial venous sinus thrombosis after exposure to the “AstraZeneca COVID-19 vaccine”: https://pubmed.ncbi.nlm.nih.gov/33918932/
23. Thrombocytopenia following P몭 zer and Moderna SARS-CoV-2 vaccination:https://pubmed.ncbi.nlm.nih.gov/33606296/
24. Severe and refractory immune thrombocytopenia occurring after SARS-CoV-2 vaccination: https://pubmed.ncbi.nlm.nih.gov/33854395/
25. Purpuric rash and thrombocytopenia after mRNA-1273 (Modern) COVID-19 vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996471/
26. Thrombosis with thrombocytopenia after messenger RNA vaccine -1273: https://pubmed.ncbi.nlm.nih.gov/34181446/
27. First dose of ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic, and hemorrhagic events in Scotland: https://www.nature.com/articles/s41591-021-01408-4
28. Exacerbation of immune thrombocytopenia after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34075578/
29. PF4 immunoassays in vaccine-induced thrombotic thrombocytopenia: https://www.nejm.org/doi/full/10.1056/NEJMc2106383

30. Antibody epitopes in vaccine-induced immune immune thrombotic thrombocytopenia: https://www.nature.com/articles/s41586-021-03744-4
31. Thrombosis with thrombocytopenia syndrome associated with COVID-19 vaccines: https://www.sciencedirect.com/science/article/abs/pii/S0735675721004381.

32. Immune thrombocytopenia associated with Pfizer-BioNTech’s COVID-19 BNT162b2 mRNA vaccine: https://www.sciencedirect.com/science/article/pii/S2214250921002018.
33. Immune thrombosis and thrombocytopenia (VITT) associated with the COVID-19 vaccine: diagnostic and therapeutic recommendations for a new syndrome: https://pubmed.ncbi.nlm.nih.gov/33987882/

34. Laboratory testing for suspicion of COVID-19 vaccine-induced thrombotic (immune) thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34138513/
35. Intracerebral haemorrhage due to thrombosis with thrombocytopenia syndrome after COVID-19 vaccination: thefirst fatal case in Korea: https://pubmed.ncbi.nlm.nih.gov/34402235/
36. Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and positive SARS-CoV-2 tests: self-controlled case series study: https://pubmed.ncbi.nlm.nih.gov/34446426/
37. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis after covid-19 vaccination; a systematic review: https://pubmed.ncbi.nlm.nih.gov/34365148/.
38. Primary adrenal insuficiency associated with thrombotic immune thrombocytopenia induced by Oxford-AstraZeneca ChAdOx1 nCoV-19 vaccine (VITT): https://pubmed.ncbi.nlm.nih.gov/34256983/
39. Cerebral venous thrombosis and vaccine-induced thrombocytopenia.a. Oxford-AstraZeneca COVID-19: a missed opportunity for a rapid return on experience: https://pubmed.ncbi.nlm.nih.gov/34033927/
40. Immune thrombocytopenia in a 22-year-old post Covid-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/33476455/
41. Secondary immune thrombocytopenia (ITP) associated with ChAdOx1 Covid-19 vaccine: case report: https://pubmed.ncbi.nlm.nih.gov/34377889/
42. Thrombosis with thrombocytopenia syndrome (TTS) following AstraZeneca ChAdOx1 nCoV-19 (AZD1222) COVID-19 vaccination: risk-benefit analysis for persons <60 years in Australia: https://pubmed.ncbi.nlm.nih.gov/34272095/
43. Bilateral superior ophthalmic vein thrombosis, ischemic stroke and immune thrombocytopenia after vaccination with ChAdOx1 nCoV-19: https://pubmed.ncbi.nlm.nih.gov/33864750/

44. Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and positive SARS-CoV-2 tests: self-controlled case series study: https://pubmed.ncbi.nlm.nih.gov/34446426/
45. First dose of ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland: https://pubmed.ncbi.nlm.nih.gov/34108714/
46. Thrombocytopenia after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34332437/.
47. A case of multiple thrombocytopenia and thrombosis following vaccination with ChAdOx1 nCoV-19 against SARS-CoV-2: https://pubmed.ncbi.nlm.nih.gov/34137813/
48. Vaccine-induced thrombotic thrombocytopenia: the elusive link between thrombosis and adenovirus-based SARS-CoV-2 vaccines: https://pubmed.ncbi.nlm.nih.gov/34191218/

49. Acute ischemic stroke revealing immune thrombotic thrombocytopenia induced by ChAdOx1 nCov-19 vaccine: impact on recanalization strategy: https://pubmed.ncbi.nlm.nih.gov/34175640/
50. Procoagulant antibody-mediated procoagulant platelets in immune thrombotic thrombocytopenia associated with SARS-CoV-2 vaccination: https://pubmed.ncbi.nlm.nih.gov/34011137/.
51. Thrombotic thrombocytopenia after vaccination with COVID-19: in search of the underlying mechanism: https://pubmed.ncbi.nlm.nih.gov/34071883/
52. Thrombosis and SARS-CoV-2 vaccines: vaccine-induced immune thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34237213/.
53. Acquired thrombotic thrombocytopenic thrombocytopenic purpura: a rare disease associated with the BNT162b2 vaccine: https://pubmed.ncbi.nlm.nih.gov/34105247/.

54. Immune complexes, innate immunity and NETosis in ChAdOx1 vaccine-induced thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34405870/.
55. Immune-mediated thrombocytopenic purpura after Pfizer-BioNTech COVID-19 vaccine in an elderly woman: https://pubmed.ncbi.nlm.nih.gov/34513446/
56. Immune-mediated thrombocytopenia associated with Ad26.COV2.S vaccine (Janssen; Johnson & Johnson): https://pubmed.ncbi.nlm.nih.gov/34469919/.
57. Transient thrombocytopenia with glycoprotein-specific platelet autoantibodies after vaccination with Ad26.COV2.S: case report: https://pubmed.ncbi.nlm.nih.gov/34516272/.
58. COVID-19 vaccine, immune thrombotic thrombocytopenia, jaundice, hyperviscosity: concern in cases with underlying hepatic problems: https://pubmed.ncbi.nlm.nih.gov/34509271/.

59. Immune thrombocytopenia after vaccination during the COVID-19 pandemic: https://pubmed.ncbi.nlm.nih.gov/34435486/
60. Vaccine-induced thrombocytopenia with severe headache: https://pubmed.ncbi.nlm.nih.gov/34525282/
61. Vaccine-induced immune thrombotic thrombocytopenia causing a severe form of cerebral venous thrombosis with a high mortality rate: a case series: https://pubmed.ncbi.nlm.nih.gov/34393988/.
62. Adenovirus interactions with platelets and coagulation and vaccine-associated autoimmune thrombocytopenia thrombosis syndrome: https://pubmed.ncbi.nlm.nih.gov/34407607/.
63. Australian and New Zealand approach to the diagnosis and treatment of vaccine-induced immune thrombosis and immune thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34490632/
64. An observational study to identify the prevalence of thrombocytopenia and anti-PF4 / polyanion antibodies in Norwegian health care workers after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/33909350/

65. A rare case of thrombosis and thrombocytopenia of the superior ophthalmic vein after ChAdOx1 nCoV-19 vaccination against SARS-CoV-2: https://pubmed.ncbi.nlm.nih.gov/34276917/
66. Thrombosis and severe acute respiratory syndrome Coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34237213/.

67. Renal vein thrombosis and pulmonary embolism secondary to vaccine-induced thrombotic immune thrombocytopenia (VITT): https://pubmed.ncbi.nlm.nih.gov/34268278/.
68. Limb ischemia and pulmonary artery thrombosis after ChAdOx1 nCoV-19 vaccine (Oxford-AstraZeneca): a case of vaccine-induced immune thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/33990339/.

69. A case of vaccine-induced immune-immune thrombotic thrombocytopenia with massive arteriovenous thrombosis: https://pubmed.ncbi.nlm.nih.gov/34059191/
70. Thrombocytopenia in an adolescent with sickle cell anemia after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34331506/
71. Vaccine-induced thrombocytopenia with severe headache: https://pubmed.ncbi.nlm.nih.gov/34525282/
72. ChAdOx1 interacts with CAR and PF4 with implications for thrombosis with thrombocytopenia syndrome: https://www.science.org/doi/10.1126/sciadv.abl8213
73. Lethal vaccine-induced immune thrombotic immune thrombocytopenia (VITT) following announcement 26.COV2.S:first documented case outside the U.S.: https://pubmed.ncbi.nlm.nih.gov/34626338/
74. A prothrombotic thrombocytopenic disorder resembling heparin-induced thrombocytopenia after coronavirus-19 vaccination: https://europepmc.org/article/PPR/PPR304469 435.
75. VITT (vaccine-induced immune thrombotic thrombocytopenia) after vaccination with ChAdOx1 nCoV-19 https://pubmed.ncbi.nlm.nih.gov/34731555/
76. Vaccine-induced immune thrombotic thrombocytopenia (VITT): a new clinicopathologic entity with heterogeneous clinical presentations: https://pubmed.ncbi.nlm.nih.gov/34159588/

77. Treatment of acute ischemic stroke associated with ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34461442/
78. Cerebral venous sinus thrombosis after vaccination: the UK experience: https://pubmed.ncbi.nlm.nih.gov/34370974/

79. Cerebral venous vein/venous sinus thrombosis with thrombocytopenia syndrome after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34373413/
80. Portal vein thrombosis due to vaccine-induced immune thrombotic immune thrombocytopenia (VITT) after Covid vaccination with ChAdOx1 nCoV-19: https://pubmed.ncbi.nlm.nih.gov/34598301/
81. Spontaneous HIT syndrome: knee replacement, infection and parallels with vaccine-induced immune thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34144250/

82. Thrombocytopenia with acute ischemic stroke and hemorrhage in a patient recently vaccinated with an adenoviral vector-based COVID-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/33877737/
83. ChAdOx1 nCoV-19 vaccine-associated thrombocytopenia: three cases of immune thrombocytopenia after 107,720 doses of ChAdOx1 vaccination in Thailand: https://pubmed.ncbi.nlm.nih.gov/34483267/.

84. Pulmonary embolism, transient ischemic attack, and thrombocytopenia after Johnson & Johnson COVID-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/34261635/
85. Neurosurgical considerations with respect to decompressive craniectomy for intracerebral hemorrhage after SARS-CoV-2 vaccination in vaccine-induced thrombotic thrombocytopenia-VITT: https://pubmed.ncbi.nlm.nih.gov/34202817/
86. Secondary thrombocytopenia after SARS-CoV-2 vaccination: case report of haemorrhage and hematoma after minor oral surgery: https://pubmed.ncbi.nlm.nih.gov/34314875/.
87. Venous thromboembolism and mild thrombocytopenia after vaccination with ChAdOx1 nCoV-19 https://pubmed.ncbi.nlm.nih.gov/34384129/

88. Fatal exacerbation of ChadOx1-nCoV-19-induced thrombotic thrombocytopenia syndrome after successful initial therapy with intravenous immunoglobulins: a rationale for monitoring immunoglobulin G levels: https://pubmed.ncbi.nlm.nih.gov/34382387/
89. A rare case of COVID-19 vaccine-induced thrombotic thrombocytopenia (VITT) affecting the venosplanchnic and pulmonary arterial circulation from a UK district general hospital: https://pubmed.ncbi.nlm.nih.gov/34535492/
90. COVID-19 vaccine-induced thrombotic thrombocytopenia: a case series: https://pubmed.ncbi.nlm.nih.gov/34527501/

91. Immune thrombocytopenia after immunization with Vaxzevria ChadOx1-S vaccine (AstraZeneca), Victoria, Australia: https://pubmed.ncbi.nlm.nih.gov/34756770/
92. Case report of immune thrombocytopenia after vaccination with ChAdOx1 nCoV-19: https://pubmed.ncbi.nlm.nih.gov/34751013/.
93. Thrombocytopenia with acute ischemic stroke and hemorrhage in a patient recently vaccinated with an adenoviral vector-based COVID-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/33877737/
94. Intracerebral hemorrhage and thrombocytopenia after AstraZeneca COVID-19 vaccine: clinical and diagnostic challenges of vaccine-induced thrombotic thrombocytopenia: https://pubmed.ncbi.nlm.nih.gov/34646685/
95. Thrombocytopenia, including immune thrombocytopenia after receiving COVID-19 mRNA vaccines reported to the Vaccine Adverse Event Reporting System (VAERS): https://pubmed.ncbi.nlm.nih.gov/34006408/

96. Newly diagnosed immune thrombocytopenia in a pregnant patient after coronavirus disease 2019 vaccination: https://pubmed.ncbi.nlm.nih.gov/34420249/
97. Thrombocytopenia in an adolescent with sickle cell anemia after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34331506/
98. Abdominal pain and bilateral adrenal hemorrhage from immune thrombotic thrombocytopenia induced by COVID-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/34546343/
99. Venous thromboembolism and mild thrombocytopenia after ChAdOx1 nCoV-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34384129/.
100. Severe immune thrombocytopenia following COVID-19 vaccination: report of four cases and review of the literature: https://pubmed.ncbi.nlm.nih.gov/34653943/.

101. Relapse of immune thrombocytopenia after COVID-19 vaccination: https://pubmed.ncbi.nlm.nih.gov/34591991/
102. Images of immune thrombotic thrombocytopenia induced by Oxford / AstraZeneca® COVID-19 vaccine: https://pubmed.ncbi.nlm.nih.gov/33962903/.
103. Adenovirus interactions with platelets and coagulation and vaccine-induced immune thrombotic thrombocytopenia syndrome: https://pubmed.ncbi.nlm.nih.gov/34407607/
104. Complicated case report of long-term vaccine-induced thrombotic immune thrombocytopenia A: https://pubmed.ncbi.nlm.nih.gov/34835275/.
105. Prevalence of thrombocytopenia, anti-platelet factor 4 antibodies, and elevated D-dimer in Thais after vaccination with ChAdOx1 nCoV-19: https://pubmed.ncbi.nlm.nih.gov/34568726/
106. Bilateral thalamic stroke: a case of COVID-19 (VITT) vaccine-induced immune thrombotic thrombocytopenia or a coincidence due to underlying risk factors: https://pubmed.ncbi.nlm.nih.gov/34820232/.

107. Successful treatment of vaccine-induced immune thrombotic thrombocytopenia in a 26-year-old female patient: https://pubmed.ncbi.nlm.nih.gov/34614491/
108. Case report: vaccine-induced immune thrombotic thrombocytopenia in a patient with pancreatic cancer after vaccination with messenger RNA-1273: https://pubmed.ncbi.nlm.nih.gov/34790684/

109. Vaccine-induced thrombotic thrombocytopenia after Ad26.COV2.S vaccination in a man presenting as acute venous thromboembolism: https://pubmed.ncbi.nlm.nih.gov/34096082/
110. Helms, J. M., Ansteatt, K. T., Roberts, J. C., Kamatam, S., Foong, K. S., Labayog, J. S., & Tarantino, M. D. (2021). Severe, Refractory Immune Thrombocytopenia Occurring After SARS-CoV-2 Vaccine. J Blood Med, 12, 221-224. doi:10.2147/JBM.S307047. https://www.ncbi.nlm.nih.gov/pubmed/33854395
111. Hippisley-Cox, J., Patone, M., Mei, X. W., Saatci, D., Dixon, S., Khunti, K., . . . Coupland, C. A. C. (2021). Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study. BMJ, 374, n1931.doi:10.1136/bmj.n1931. https://www.ncbi.nlm.nih.gov/pubmed/34446426

112. Lee, E. J., Cines, D. B., Gernsheimer, T., Kessler, C., Michel, M., Tarantino, M. D., . . . Bussel, J. B. (2021). Thrombocytopenia following P몭 zer and Moderna SARS-CoV-2 vaccination. Am J Hematol, 96(5), 534-537. doi:10.1002/ajh.26132. https://www.ncbi.nlm.nih.gov/pubmed/33606296
113. Welsh, K. J., Baumblatt, J., Chege, W., Goud, R., & Nair, N. (2021). Thrombocytopenia including immune thrombocytopenia after receipt of mRNA COVID-19 vaccines reported to the Vaccine Adverse Event Reporting System (VAERS). Vaccine, 39(25), 3329-3332.doi:10.1016/j.vaccine.2021.04.054. https://www.ncbi.nlm.nih.gov/pubmed/34006408

114. Relapse of immune thrombocytopenia after covid-19 vaccination in young male patient: https://pubmed.ncbi.nlm.nih.gov/34804803/.
115. Peduncular, symptomatic cavernous bleeding after immune thrombocytopenia-induced SARS-CoV-2 vaccination: https://pubmed.ncbi.nlm.nih.gov/34549178/.
116. Vaccine-Induced Immune Thrombotic Thrombocytopenia with Disseminated Intravascular Coagulation and Death following the ChAdOx1 nCoV-19 Vaccine: https://www.strokejournal.org/article/S1052-3057(21)00341-4/fulltext
     
     Kilde: Dr. Mark Trozzi

Illustrasjon: adobe
Skjermdump: artikkel NRK