Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in cl...Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.展开更多
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 adolescen...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 .展开更多
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)...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.展开更多
Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-...Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-molecular-weight heparin(LMWH).This study aims to summarize the clinical features of HIT in patients undergoing cardiac surgery.展开更多
Background: Spontaneous heparin induced thrombocytopenia (HIT) is a medical phenomenon whereby patients develop clinical and laboratory features of HIT without prior exposure to heparin. Aim: We present a patient who ...Background: Spontaneous heparin induced thrombocytopenia (HIT) is a medical phenomenon whereby patients develop clinical and laboratory features of HIT without prior exposure to heparin. Aim: We present a patient who underwent bilateral total knee replacement complicated by spontaneous HIT causing bilateral adrenal hemorrhage and deep vein thrombosis. Our patient had no prior history of heparin exposure. We reconcile our patient’s presentation with other case reports of spontaneous HIT in patients who had orthopaedic surgery. Conclusion: Spontaneous HIT is a rare but potentially devastating complication associated with total knee arthroplasty.展开更多
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...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,展开更多
Background:Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.Case presentation:A 78-year-old man who underwent a successful lum...Background:Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.Case presentation:A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes.The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction.Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses.His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocy-topenia despite no previous exposure to heparin products.Conclusions:This case illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes,an inferior wall myocardial infarction,and bilateral lower extremity deep vein thromboses,with concern for sequelae of spontaneous heparin-induced thrombo-cytopenia.展开更多
BACKGROUND Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis,and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice.But one u...BACKGROUND Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis,and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice.But one uncommon side effect of lowmolecular-weight heparin is heparin-induced thrombocytopenia(HIT),which can develop into thrombosis if not caught early or managed incorrectly.CASE SUMMARY We present a case of a patient who underwent hip arthroplasty and experienced thrombocytopenia due to HIT on the 9th d following the application of lowmolecular-weight heparin anticoagulation.We did not diagnose HIT in time and applied 1 unit of platelets to the patient,which led to thrombosis.Luckily,the patient recovered following effective and timely surgery and treatment with rivaroxaban.CONCLUSION Patients using low-molecular-weight heparin after lower limb surgery need to have their platelet counts regularly checked.If HIT develops,platelet treatment should be given with caution.展开更多
A 72-year-old man with abdominal aortic aneurysm and angina pectoris underwent coronary artery bypass grafting (CABG) prior to abdominal aortic surgery. Perioperatively, he developed thrombocytopenia ((29,000 mm3), wh...A 72-year-old man with abdominal aortic aneurysm and angina pectoris underwent coronary artery bypass grafting (CABG) prior to abdominal aortic surgery. Perioperatively, he developed thrombocytopenia ((29,000 mm3), which was suggested as heparin-induced thrombocytopenia. Cardiac status was also aggravated at the same time, suggestive of bypass graft thrombosis. The results of platelet factor 4 (pf4) antibody test were negative, but platelet aggregation test was positive for heparin. Heparin was immediately discontinued, and replaced by argatroban;the patient’s cardiac status improved. One month later, he underwent abdominal aortic surgery using argatroban without issues related to anticoagulation and hemostasis. Autologous donated fresh blood prepared by the “switch-back” method was also used in this case, and its value was confirmed.展开更多
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...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 intraoperative transe?sophageal echocardiography (TEE) in the surgical management of this patient.展开更多
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 heparin.HITT after pan...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 heparin.HITT after pancreaticoduodenectomy(PD)has not been reported before.Herein,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 surgery.An open PD procedure was performed,and the operation was smooth.No heparin was used after surgery.Nine 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 limb.HIT-antibody was 6.3 U/mL(0-0.6).The diagnosis of HITT was confirmed.Fondaparinux was used.On postoperative day(POD)23,the platelet recovered to the normal range.On POD 27,she was discharged without thromboembolism or active bleeding,and oral rivaroxaban was prescribed.One month after discharge,the platelet remained normal,and she did not complain of discomfort.展开更多
Thrombocytopenia (defined as platelet count <sup>9</sup>/L) is present in 7% - 12% of pregnant women at delivery. Although there are mild etiologies of this condition that are often diagnosed incidentally,...Thrombocytopenia (defined as platelet count <sup>9</sup>/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.展开更多
Background: Diagnosis of heparin-induced thrombocytopenia (HIT) is challenging. This study aimed to compare the diagnostic performance of HIT expert probability (HEP) and 4T scores, and to evaluate the inter-observer ...Background: Diagnosis of heparin-induced thrombocytopenia (HIT) is challenging. This study aimed to compare the diagnostic performance of HIT expert probability (HEP) and 4T scores, and to evaluate the inter-observer reliability for the 4T score in a clinical setting. Methods: This prospective study included HIT-suspected patients between 2016 and 2018. Three hematologists assessed the HEP and 4T scores. Correlations between scores and anti-platelet factor 4 (anti-PF4)/heparin antibodies were evaluated. Receiver operating characteristic curves and area under the curve (AUC) were used to assess the predictive accuracy of these two scoring models. The intraclass correlation coefficient (ICC) was used to assess the inter-observer agreement of 4T scores between residents and hematologists. Results: Of the 89 subjects included, 22 (24.7%) were positive for anti-PF4/heparin antibody. The correlations between antibody titer and either HEP or 4T scores were similar (r = 0.392, P < 0.01 for the HEP score;r = 0.444, P < 0.01 for the 4T score). No significant difference in the diagnostic performance was displayed between these two scores (AUC for the HEP score: 0.778 vs. AUC for the 4T score: 0.741, P = 0.357). Only 72 4T scores were collected from the residents, with a surprisingly low percentage of observers (43.1%) presenting the four individual item scores which made up their 4T score. The AUC of 4T score assessed by residents and hematologists was 0.657 (95% confidence interval [CI]: 536–0.765) and 0.780 (95% CI: 0.667–0.869, P < 0.05), respectively. The ICC of 4T score between residents and hematologists was 0.49 (95% CI: 0.29–0.65, P < 0.01), demonstrating a fair inter-observer agreement. Conclusions: The HEP score does not display a better performance for predicting HIT than the 4T score. With the unsatisfactory completion rate, the inter-observer agreement of 4T score in a tertiary hospital is fair, underscoring the necessity for continuing education for physicians.展开更多
Background:Thrombocytopenia commonly occurs early after liver transplantation.Heparin,usually administered as anticoagulant ther-apy for thrombosis,a common complication after liver transplantation,may cause heparin-i...Background:Thrombocytopenia commonly occurs early after liver transplantation.Heparin,usually administered as anticoagulant ther-apy for thrombosis,a common complication after liver transplantation,may cause heparin-induced thrombocytopenia.Heparin-induced thrombocytopenia is a rare but life-threatening complication,and its diagnosis after liver transplantation is challenging.Case presentation:We report a case of heparin-induced thrombocytopenia after living donor liver transplantation with a good out-come because of early diagnosis and discontinuation of heparin.After liver transplantation,the platelet count usually reaches a nadir on postoperative days 3–5 and gradually recovers.In contrast,heparin-induced thrombocytopenia typically occurs 5–10 days after heparin administration;therefore,if heparin is started intraoperatively,then thrombocytopenia will occur on postoperative days 5–10.Conclusion:Monitoring the trend and timing of thrombocytopenia and detailed examination for thrombosis may help confirm the diag-nosis of heparin-induced thrombocytopenia in the early stage after liver transplantation.展开更多
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 pat...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.展开更多
文摘Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
文摘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 .
文摘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.
文摘Objective Heparin-induced thrombocytopenia(HIT)is a complication characterized by thrombocytopenia,hemorrhage and/or thrombosis,which is caused by initial or repeated application of unfractionated heparin(UFH)and low-molecular-weight heparin(LMWH).This study aims to summarize the clinical features of HIT in patients undergoing cardiac surgery.
文摘Background: Spontaneous heparin induced thrombocytopenia (HIT) is a medical phenomenon whereby patients develop clinical and laboratory features of HIT without prior exposure to heparin. Aim: We present a patient who underwent bilateral total knee replacement complicated by spontaneous HIT causing bilateral adrenal hemorrhage and deep vein thrombosis. Our patient had no prior history of heparin exposure. We reconcile our patient’s presentation with other case reports of spontaneous HIT in patients who had orthopaedic surgery. Conclusion: Spontaneous HIT is a rare but potentially devastating complication associated with total knee arthroplasty.
文摘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,
文摘Background:Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.Case presentation:A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes.The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction.Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses.His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocy-topenia despite no previous exposure to heparin products.Conclusions:This case illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes,an inferior wall myocardial infarction,and bilateral lower extremity deep vein thromboses,with concern for sequelae of spontaneous heparin-induced thrombo-cytopenia.
文摘BACKGROUND Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis,and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice.But one uncommon side effect of lowmolecular-weight heparin is heparin-induced thrombocytopenia(HIT),which can develop into thrombosis if not caught early or managed incorrectly.CASE SUMMARY We present a case of a patient who underwent hip arthroplasty and experienced thrombocytopenia due to HIT on the 9th d following the application of lowmolecular-weight heparin anticoagulation.We did not diagnose HIT in time and applied 1 unit of platelets to the patient,which led to thrombosis.Luckily,the patient recovered following effective and timely surgery and treatment with rivaroxaban.CONCLUSION Patients using low-molecular-weight heparin after lower limb surgery need to have their platelet counts regularly checked.If HIT develops,platelet treatment should be given with caution.
文摘A 72-year-old man with abdominal aortic aneurysm and angina pectoris underwent coronary artery bypass grafting (CABG) prior to abdominal aortic surgery. Perioperatively, he developed thrombocytopenia ((29,000 mm3), which was suggested as heparin-induced thrombocytopenia. Cardiac status was also aggravated at the same time, suggestive of bypass graft thrombosis. The results of platelet factor 4 (pf4) antibody test were negative, but platelet aggregation test was positive for heparin. Heparin was immediately discontinued, and replaced by argatroban;the patient’s cardiac status improved. One month later, he underwent abdominal aortic surgery using argatroban without issues related to anticoagulation and hemostasis. Autologous donated fresh blood prepared by the “switch-back” method was also used in this case, and its value was confirmed.
文摘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 intraoperative transe?sophageal echocardiography (TEE) in the surgical management of this patient.
文摘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 heparin.HITT after pancreaticoduodenectomy(PD)has not been reported before.Herein,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 surgery.An open PD procedure was performed,and the operation was smooth.No heparin was used after surgery.Nine 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 limb.HIT-antibody was 6.3 U/mL(0-0.6).The diagnosis of HITT was confirmed.Fondaparinux was used.On postoperative day(POD)23,the platelet recovered to the normal range.On POD 27,she was discharged without thromboembolism or active bleeding,and oral rivaroxaban was prescribed.One month after discharge,the platelet remained normal,and she did not complain of discomfort.
文摘Thrombocytopenia (defined as platelet count <sup>9</sup>/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.
文摘Background: Diagnosis of heparin-induced thrombocytopenia (HIT) is challenging. This study aimed to compare the diagnostic performance of HIT expert probability (HEP) and 4T scores, and to evaluate the inter-observer reliability for the 4T score in a clinical setting. Methods: This prospective study included HIT-suspected patients between 2016 and 2018. Three hematologists assessed the HEP and 4T scores. Correlations between scores and anti-platelet factor 4 (anti-PF4)/heparin antibodies were evaluated. Receiver operating characteristic curves and area under the curve (AUC) were used to assess the predictive accuracy of these two scoring models. The intraclass correlation coefficient (ICC) was used to assess the inter-observer agreement of 4T scores between residents and hematologists. Results: Of the 89 subjects included, 22 (24.7%) were positive for anti-PF4/heparin antibody. The correlations between antibody titer and either HEP or 4T scores were similar (r = 0.392, P < 0.01 for the HEP score;r = 0.444, P < 0.01 for the 4T score). No significant difference in the diagnostic performance was displayed between these two scores (AUC for the HEP score: 0.778 vs. AUC for the 4T score: 0.741, P = 0.357). Only 72 4T scores were collected from the residents, with a surprisingly low percentage of observers (43.1%) presenting the four individual item scores which made up their 4T score. The AUC of 4T score assessed by residents and hematologists was 0.657 (95% confidence interval [CI]: 536–0.765) and 0.780 (95% CI: 0.667–0.869, P < 0.05), respectively. The ICC of 4T score between residents and hematologists was 0.49 (95% CI: 0.29–0.65, P < 0.01), demonstrating a fair inter-observer agreement. Conclusions: The HEP score does not display a better performance for predicting HIT than the 4T score. With the unsatisfactory completion rate, the inter-observer agreement of 4T score in a tertiary hospital is fair, underscoring the necessity for continuing education for physicians.
文摘Background:Thrombocytopenia commonly occurs early after liver transplantation.Heparin,usually administered as anticoagulant ther-apy for thrombosis,a common complication after liver transplantation,may cause heparin-induced thrombocytopenia.Heparin-induced thrombocytopenia is a rare but life-threatening complication,and its diagnosis after liver transplantation is challenging.Case presentation:We report a case of heparin-induced thrombocytopenia after living donor liver transplantation with a good out-come because of early diagnosis and discontinuation of heparin.After liver transplantation,the platelet count usually reaches a nadir on postoperative days 3–5 and gradually recovers.In contrast,heparin-induced thrombocytopenia typically occurs 5–10 days after heparin administration;therefore,if heparin is started intraoperatively,then thrombocytopenia will occur on postoperative days 5–10.Conclusion:Monitoring the trend and timing of thrombocytopenia and detailed examination for thrombosis may help confirm the diag-nosis of heparin-induced thrombocytopenia in the early stage after liver transplantation.
文摘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.
