Heparin-induced thrombocytopenia in the emergency department
| Autor: | Alane Drexler, John L. Francis, Robert Levine, Marcie J. Hursting, Bruce E. Lewis |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class Platelet Factor 4 Antibodies Diagnosis Differential Thromboembolism Heparin-induced thrombocytopenia Intensive care medicine Humans Coronary Artery Bypass Stroke Aged Venous Thrombosis Heparin business.industry Anticoagulant Middle Aged medicine.disease Thrombocytopenia Thrombosis Surgery Pulmonary embolism Venous thrombosis Emergency Medicine Female Intracranial Thrombosis Emergency Service Hospital Pulmonary Embolism business medicine.drug |
| Zdroj: | Annals of Emergency Medicine. 44:511-515 |
| ISSN: | 0196-0644 |
| DOI: | 10.1016/j.annemergmed.2004.06.004 |
| Popis: | We describe 3 patients who presented to the emergency department (ED) with stroke, deep venous thrombosis, or pulmonary embolism and renal failure after undergoing cardiac surgery 7 to 17 days earlier. Their onset of thrombosis after previous heparin exposure was temporally plausible for complications of heparin-induced thrombocytopenia, an immune-mediated thrombotic disorder triggered by heparin. The patients had normal platelet counts at presentation, yet each had circulating heparin-induced thrombocytopenia antibodies that were ultimately confirmed. Two patients had heparin reexposure in the ED, 1 of whom developed thrombocytopenia with new thrombosis and died. Alternative parenteral anticoagulation prevented further thrombosis in 2 patients. Because heparin use can be catastrophic in patients with heparin-induced thrombocytopenia, physicians should be vigilant in suspecting heparin-induced thrombocytopenia in patients with thrombosis after recent hospitalization or heparin exposure. Alternative anticoagulants are available for these at-risk patients. |
| Databáze: | OpenAIRE |
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