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
/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
/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
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved