Reactions 1704, p182 - 2 Jun 2018 Heparin-induced thrombocytopenia: case report A 72-year-old woman developed heparin-induced thrombocytopenia (HIT) during treatment with heparin for prophylaxis of venous thromboembolism [route and duration of treatment to reaction onset not stated]. The woman presented to an outside emergency department three times after a 4-day history of neck swelling, pain and drainage. On admission to another hospital, she was taken to the operation room for necrotising fasciitis management. She received heparin 5000 units every eight hours for venous thromboembolism prophylaxis. Her platelet count upon heparin initiation was 379 x10 /L. On hospital day 6, the platelet count further increased to 540 x10 /L. On hospital day 8, she underwent a right lateral tibial plateau fracture fixation. On hospital day 9, the platelet count reduced to 176 x10 /L. HIT rapid assay was found to be positive. Hence, HIT was suspected. The woman’s treatment with heparin was discontinued. Post-surgery, she received treatment with apixaban for venous thromboembolism prophylaxis. Four days later, the serotonin release assay was found positive, which confirmed the diagnosis of HIT. Her apixaban therapy was was continued throughout the hospitalisation without any adverse events. On hospital day 15, she was discharged with a platelet count of 33 x10 /L. Her treatment with apixaban was continued for two months after the right tibial surgery. No bleeding or thrombosis was noted during follow-ups. Author comment: "Heparin was discontinued due to suspected HIT after a positive [heparin-induced thrombocytopenia] rapid assay." Stefanik M, et al. Apixaban in heparin-induced thrombocytopenia (HIT). Journal of the American Geriatrics Society 66 (Suppl. 2): S263, Apr 2018. Available from: URL: http://doi.org/10.1111/jgs.15376 [abstract] - USA 803323423 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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