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heparin-induced thrombocytopenia associated with pulmonary embolism after total knee arthroplasty:a case report and review of literatures

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Journal of Medical Colleges of PLA(China) 2013年第2期28卷 113-119页

作者： YUAN Hengfeng XU Weidong Department of Orthopedics Changhai HospitalSecond Military Medical University

Type II heparin-induced thrombocytopenia （HIT） is a life-threatening adverse drug reaction initiated by heparin administration. We described a rare case of LMWH-induced HIT complicated with proven pulmonary embolism （PE） in a 75-year-old male patient who hospitalized with diagnose of right knee osteoarthritis and was underwent total knee arthroplasty The patient was successfully treated with argatroban. Early recognition and timely altemative therapy are of great importance in the treatment of this severe disorder,

关键词： heparin-induced thrombocytopenia Pulmonary embolism Total knee arthroplasty

heparin-induced thrombocytopenia in solid organ transplant recipients: The current scientific knowledge

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World Journal of Transplantation 2016年第1期6卷 165-173页

作者： Volker Assfalg Norbert Hüser Department of Surgery Klinikum rechts der Isar der Technischen Universit?t München

Exposure to heparin is associated with a high incidence of immunization against platelet factor 4(PF4)/heparin complexes. A subgroup of immunized patients is at risk of developing heparin-induced thrombocytopenia(HIT), an immune mediated prothrombotic adverse drug effect. Transplant recipients are frequently exposed to heparin either due to the underlying end-stage disease, which leads to listing and transplantation or during the transplant procedure and the perioperative period. To review the current scientific knowledge on antiheparin/PF4 antibodies and HIT in transplant recipients a systematic Pub Med literature search on articles in English language was performed. The definition of HIT is inconsistent amongst the publications. Overall, six studies and 15 case reports have been published on HIT before or after heart, liver, kidney, and lung transplantation, respectively. The frequency of seroconversion for anti-PF4/heparin antibodies ranged between 1.9% and 57.9%. However, different methods to detect anti-PF4/heparin antibodies were applied. In none of the studies HIT-associated thromboembolic events or fatalities were observed. More importantly, in patients with a history of HIT, reexposure to heparin during transplantation was not associated with thrombotic complications. Taken together, the overall incidence of HIT after solid organ transplantation seems to be very low. However, according to the current knowledge, cardiac transplant recipients may have the highest risk to develop HIT. Different alternative suggestions for heparin-free anticoagulation have been reported for recipients with suspected HIT albeit no official recommendations on management have been published for this special collective so far.

关键词： heparin-induced thrombocytopenia heparininduced thrombocytopenia heparin Organ Transplantation

heparin-induced thrombocytopenia thrombosis after pancreaticoduodenectomy without definitive prophylactic or therapeutic use of heparin:a case report

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Journal of Pancreatology 2024年第2期7卷 164-166页

作者： Mengyi Wang Nan Huang Qiaofei Liu Quan Liao Department of General Surgery Key Laboratory of Research in Pancreatic TumorState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical College1#ShuaifuyuanDongcheng DistrictBeijing 100730China

heparin-induced thrombocytopenia thrombosis(HITT)is a rare and potentially life-threatening complication after abdominal surgery,and it always occurs after the prophylactic or therapeutic use of *** after pancreaticoduodenectomy(PD)has not been reported ***,we reported a case of HITT after PD without prophylactic or therapeutic use of heparin.A 74-year-old female patient who suffered resectable pancreatic head cancer was transferred to our center for *** open PD procedure was performed,and the operation was *** heparin was used after *** days after surgery,the platelet sharply declined to 48×10^(9)/L(100-350),and the D-dimer soared up to 33.56 mg/L(0-0.55).Ultrasound examination showed vein thrombosis in both the lower limb and the right upper ***-antibody was 6.3 U/mL(0-0.6).The diagnosis of HITT was *** was *** postoperative day(POD)23,the platelet recovered to the normal *** POD 27,she was discharged without thromboembolism or active bleeding,and oral rivaroxaban was *** month after discharge,the platelet remained normal,and she did not complain of discomfort.

关键词： heparin-induced thrombocytopenia Pancreatic cancer Pancreaticoduodenectomy Perioperative anticoagulation

Cerebral venous thrombosis and heparin-induced thrombocytopenia in an 18-year old male with severe ulcerative colitis

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World Journal of Gastroenterology 2008年第28期14卷 4576-4579页

作者： Gudrun Scheving Thorsteinsson Maria Magnussson Lena M Hallberg Nils Gunnar Wahlgren Fredrik Lindgren Petter Malmborg Thomas H Casswall Department of Pediatrics Karolinska University Hospital and CLINTECKarolinska InstitutetStockholm Se-141 86Sweden Pediatric Coagulation Unit Karolinska University Hospital and CLINTECKarolinska InstitutetStockholm Se-141 86Sweden Division of Radiology Karolinska University Hospital and Karolinska InstitutetStockholm Se-141 86Sweden Clinical Neuroscience Unit Karolinska University Hospital and Karolinska InstitutetStockholm Se-141 86Sweden Division of Paediatric Gastroenterology Hepatology & NutritionKarolinska University Hospital and CLINTECKarolinska InstitutetSe-141 86 StockholmSweden

The risk of thromboembolism is increased in inflammatory bowel disease and its symptoms may be overlooked. Furthermore, its treatment can be complex and is not without complications. We describe a case of an adolescent boy who developed a cerebral sinus venous thrombosis during a relapse of his ulcerative colitis and who, while on treatment with heparin, developed heparin-induced thrombocytopenia (HIT). The treatment was then switched to fondaparinux, a synthetic and selective inhibitor of activated factor .

关键词： Inflammatory bowel disease Ulcerative colitis Cerebral venous thrombosis heparin-induced thrombocytopenia Fondaparinux

A rare case of arterial thrombosis due to heparin-induced thrombocytopenia

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Chinese Medical Journal 2011年第22期124卷 3830-3833页

作者： LI Lei GAO Wei ZHANG Fu-chun HAN Jiang-li ZHANG Yuan WANG Gui-song SHE Fei GUO Li-jun Department of Cardiology Peking University Third Hospital Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides Ministry of Health Key Laboratory of Molecular Cardiovascular Sciences Ministry of Education Beijing 100191 China

A 78-year-old man presented with an eight-hour history of chest distress. Electrocardiograph and serum cardiac enzymes were suggestive of acute inferior myocardial infarction with right ventricular infarction. The patient, who underwent emergency percutaneous coronary intervention, suffered from thrombocytopenia presenting with cerebral infarction and myocadial reinfarction during haparin exposure. The laboratory test for heparin-induced thrombocytopenia （HIT） specific antibodies （heparin-platelet factor, PF4） was positive. The case was diagnosed as arteries thrombosis due to heparin-induced thrombocytopenia; the patient died after cessation of heparin.

关键词： heparin-induced thrombocytopenia arterial thrombosis

Another Example of Devastating Complication of heparin-induced thrombocytopenia Post-Cardiac Surgery

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International Journal of Clinical Medicine 2010年第2期1卷 75-77页

作者： Karine Toledano Francois Beique Donald Hickey Jean-Francois Morin Department of Anesthesia and Cardiac Surgery SMBD Jewish General HospitalMcGill UniversityMontrealCanada

We describe a patient who developed catastrophic consequences of heparin-induced thrombocytopenia (HIT) post car?diac surgery, for which she required reoperation using CPB. We also illustrate the impact of intraoperat... 详细信息

关键词： Danaparoid heparin-induced thrombocytopenia Stroke Emboli

Factors predisposing to thrombosis after major joint arthroplasty

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World Journal of Orthopedics 2020年第9期11卷 400-410页

作者： Zoe H Dailiana Nikolaos Stefanou Sokratis Varitimids Nikolaos Rigopoulos Apostolos Dimitroulias TheofilosKarachalios Konstantinos N Malizos Despoina Kyriakou Panagoula Kollia Department of Orthopaedic Surgery Faculty of MedicineSchool of Health SciencesUniversity of ThessalyLarissa 41500Greece Laboratory of Haematology-Transfusion Medicine Faculty of MedicineSchool of Health SciencesUniversity of ThessalyLarissa 41500Greece Department of Human Genetics Faculty of BiologyNational and Kapodistrian University of AthensAthens 11635Greece

BACKGROUND Total joint arthroplasty is one of the most common options for end stage osteoarthritis of major ***,we must take into account that thrombosis after hip/knee arthroplasty may be related to mutations in genes encoding for blood coagulation factors and immune reactions to anticoagulants[heparininduced thrombocytopenia(HIT)/thrombosis].Identifying and characterizing genetic risk should help to develop diagnostic strategies or modify anticoagulant options in the search for etiological mechanisms that cause thrombophilia following major orthopedic *** To evaluate the impact of patients’coagulation profiles and to study specific pharmacologic factors in the development of post-arthroplasty *** In 212(51 male and 161 female)patients that underwent primary total hip arthroplasty(100)or total knee arthroplasty(112)due to osteoarthritis during a period of 1 year,platelet counts and anti-platelet factor 4(PF4)/heparin antibodies were evaluated pre/postoperatively,and antithrombin III,methylenetetrahydrofolate reductase,factor V and prothrombin gene mutations were evaluated *** a minimum follow-up of 3 years,196 patients receiving either low-molecular-weight heparins(173)or fondaparinux(23)were monitored for the development of thrombocytopenia,anti-PF4/heparin antibodies,HIT,and *** Of 196 patients,32 developed thrombocytopenia(nonsignificant correlation between anticoagulant type and thrombocytopenia,P=0134.)and 18 developed anti-PF4/heparin antibodies(12/173 for low-molecular-weight heparins and 6/23 for fondaparinux;significant correlation between anticoagulant type and appearance of antibodies,P=0.005).Odds of antibody emergence:8.2%greater in patients receiving fondaparinux than low-molecular-weight *** mutations in factor II or V(two heterozygotes for both factor V and II)were identified in 15 of 196 *** low protein C and/or S levels were found in 3 of 196(1.5%)patients,while

关键词： Arthroplasty Thrombosis heparin-induced thrombocytopenia Coagulation factors Low-molecular-weight heparin Fondaparinux

Diagnostic Approach of thrombocytopenia in Pregnancy: A Review

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 784-792页

作者： John Alexander Yela Cono Sandra Ximena Olaya David Ricardo Murillo-Garcia Brahyan Osorio Juan David Hernández Susana Lopez de Valencia Hospital Popayán Colombia Institución Universitaria Visión de las Américas Pereira Colombia The Jewish Hospital Cincinnati USA Universidad Tecnológica de Pereira Pereira Colombia

thrombocytopenia (defined as platelet count 9/L) is present in 7% - 12% of pregnant women at delivery. Although there are mild etiologies of this condition that are often diagnosed incidentally, there are more severe causes that can be life threating. thrombocytopenia also has a great implication in surgical risk and regional anesthesia. A structured evaluation of thrombocytopenia is necessary to allow an adequate diagnostic approach. Here we summarized the current knowledge of thrombocytopenia in pregnancy.

关键词： Pregnancy thrombocytopenia Gestational thrombocytopenia Preeclampsia HELLP Syndrome Immune thrombocytopenia Thrombotic Microangiopathy heparin-induced thrombocytopenia Disseminated Intravascular Coagulation