Acute Pulmonary Thromboembolism Induced by Prophylactic Heparin Use and a Heparin-Coated Catheter A Case of Heparin-Induced Thrombocytopenia and Thrombosis Syndrome

Akimitsu Nasuno; Taku Matsubara; Tomoyuki Hori; Kotaro Higuchi; Keiichi Tsuchida; Tohru Mezaki; Takayuki Tanaka; Kazuhiro Hanzawa; Hisanaga Moro; Jun-ichi Hayashi; Ken-ichi Tanaka; Ichiro Fuse; Yoshifusa Aizawa

doi:10.1253/circj.67.96

Case Report

Acute Pulmonary Thromboembolism Induced by Prophylactic Heparin Use and a Heparin-Coated Catheter

A Case of Heparin-Induced Thrombocytopenia and Thrombosis Syndrome

Akimitsu Nasuno, Taku Matsubara, Tomoyuki Hori, Kotaro Higuchi, Keiichi Tsuchida, Tohru Mezaki, Takayuki Tanaka, Kazuhiro Hanzawa, Hisanaga Moro, Jun-ichi Hayashi, Ken-ichi Tanaka, Ichiro Fuse, Yoshifusa Aizawa

Author information

Akimitsu Nasuno
First Department of Internal Medicine
Taku Matsubara
First Department of Internal Medicine
Tomoyuki Hori
First Department of Internal Medicine
Kotaro Higuchi
First Department of Internal Medicine
Keiichi Tsuchida
First Department of Internal Medicine
Tohru Mezaki
First Department of Internal Medicine
Takayuki Tanaka
First Department of Internal Medicine
Kazuhiro Hanzawa
Second Department of Surgery
Hisanaga Moro
Second Department of Surgery
Jun-ichi Hayashi
Second Department of Surgery
Ken-ichi Tanaka
Department of Obstetrics and Gynecology, Niigata University Medical Hospital
Ichiro Fuse
First Department of Internal Medicine
Yoshifusa Aizawa
First Department of Internal Medicine

Keywords: Argatroban, Heparin, Heparin-coated catheter, Pulmonary embolism, Thrombocytopenia, Venous thrombosis

JOURNAL FREE ACCESS

2003 Volume 67 Issue 1 Pages 96-98

DOI https://doi.org/10.1253/circj.67.96

Details

Abstract

Heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) is a potentially life-threatening side effect of heparin therapy, triggered by an immune response, and has been reported to be related not only to the therapeutic use of heparin but also to heparin-coated catheters. A 45-year-old woman with intrapelvic malignancy developed an acute pulmonary thromboembolism (PE) after hysterectomy despite prophylactic heparin use. Subsequent large doses of heparin for treatment of the PE exacerbated the thrombocytopenia and, moreover, a large thrombus formed around the heparin-coated central venous catheter. Anti-heparin-platelet factor 4 complex antibody and heparin-induced platelet aggregation assay were positive, so the diagnosis was HITTS, and heparin was replaced by argatroban after carrying out thrombectomy. This therapy was successful, and the patient made favorable progress. (Circ J 2003; 67: 96 - 98)

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