Heparin-induced thrombocytopenia (HIT) is a rare immune-mediated complication of heparin administration. A potentially life-threatening complication, HIT is difficult to diagnose in patients in the intensive care unit after cardiac surgery because there can be multiple reasons for thrombocytopenia. Moreover, immune-mediated platelet consumption may be masked by reactive thrombocytosis, which is common in the typical postoperative course after cardiac surgery. We report the case of a 57-year-old male patient who developed fulminant pulmonary embolism following heparin-induced thrombosis without thrombocytopenia after off-pump coronary artery bypass surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1532/HSF98.20091057 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anti-platelet factor 4 antibody-mediated disorders: an updated narrative review.
Semin Thromb Hemost
January 2025
of Medicine, Universita degli Studi di Padova Scuola di Medicina e Chirurgia, Padova, Italy.
Anti-platelet factor 4 (PF4) antibody-mediated disorders are a heterogenous group of diseases characterized by the presence of highly pathogenic immunoglobulins G directed against PF4 and/or PF4/heparin complexes. These antibodies are able to activate platelets, neutrophils and monocytes, thus resulting in thrombocytopenia and a hypercoagulable state. Five different forms of anti-PF4 antibody-mediated disorders have been identified: i) classic heparin-induced thrombocytopenia (cHIT) mediated by heparin and certain polyanionic drugs; ii) autoimmune HIT (aHIT) characterized by the presence of anti-PFA/polyanion antibodies that can strongly activate platelets even in the absence of heparin; iii) spontaneous HIT (spHIT) characterized by thrombocytopenia and thrombosis without proximate exposure to heparin, with two subtypes: (a) post-total knee arthroplasty, and cardiac surgery using cardiopulmonary bypass or extracorporeal membrane oxygenation, and (b) post-infections; iv) vaccine-induced immune thrombotic thrombocytopenia (VITT) characterized by thrombocytopenia, arterial and venous thrombosis, or secondary hemorrhage after receiving adenoviral vector vaccines for COVID-19; v) VITT-like disorders triggered by adenoviral infections.
View Article and Find Full Text PDFIdentification of disulfide bond-linking sites in biosynthesized platelet factor 4 by establishing a partial reduction method without alkylation.
Anal Methods
January 2025
College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, 100029, P.R. China.
Platelet factor 4 (PF4), a specific protein primarily found in megakaryocytes and platelet α-granules, plays an essential role in the coagulation process. It carries a high positive charge and thus has a unique ability to readily form complexes with negatively charged heparin. This interaction between PF4 and heparin plays a crucial role in platelet aggregation and thrombosis, resulting in heparin-induced thrombocytopenia (HIT).
View Article and Find Full Text PDFDanaparoid-Consensus Recommendations on Its Clinical Use.
Pharmaceuticals (Basel)
November 2024
Independent Researcher, 5345 MT Oss, The Netherlands.
(1) Background: Danaparoid sodium is a heparinoid antithrombotic that has been used for over 40 years for prophylaxis of DVT in non-HIT patients and for the treatment of heparin-induced thrombocytopenia (HIT) with and without thrombosis. This update summarises current information on its pharmacology and reviews danaparoid dose management in a broad spectrum of clinical situations, including off-label indications. (2) Methods: Evidence from published clinical studies, case reports, compassionate use of danaparoid, and spontaneously reported serious adverse events is summarised and analysed by an interdisciplinary expert group to develop a consensus on dosing regimens of danaparoid for complex clinical situations, including vulnerable patient populations.
View Article and Find Full Text PDFSafe and effective anticoagulation use: case studies in anticoagulation stewardship.
J Thromb Haemost
December 2024
Division of Hospital Medicine, Henry Ford Health, Detroit, Michigan, USA. Electronic address: https://twitter.com/kaatz_scott.
Anticoagulant use is prevalent and associated with significant potential for harm. Anticoagulation stewardship practice has emerged to address care gaps and promote safe, effective, and cost-conscious anticoagulation use across health care systems. We present 4 patient cases describing common challenges in anticoagulation management: inappropriate dosing of direct oral anticoagulants, the diagnosis and management of heparin-induced thrombocytopenia, periprocedural anticoagulation management, and heavy menstrual bleeding on anticoagulation.
View Article and Find Full Text PDFHeparin-induced thrombocytopenia during anticoagulation therapy for COVID-19-related pulmonary embolism: A case report.
Medicine (Baltimore)
December 2024
Civil Aviation General Hospital, Beijing, China.
Rationale: One of the main characteristics of COVID-19 is the high incidence of venous thromboembolism, particularly pulmonary embolism. Anticoagulation therapy is the primary treatment for pulmonary embolism. Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse reaction to heparin that occurs during its use of heparin drugs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!