Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Severe heparin-induced thrombocytopenia: when the obvious is not obvious, a case report. | Journal of Medical Case Reports BioMed Central Open Access Case report Severe heparin-induced thrombocytopenia when the obvious is not obvious a case report Graham M Cormack and Larry J Kaufman Address Department of Medicine University of Hawaii and St. Francis Medical Center Honolulu HI USA Email Graham M Cormack - grahamcormack@ Larry J Kaufman - bjammin@ Corresponding author Published 30 April 2007 Received 18 December 2006 Journal of Medical Case Reports 2007 1 13 doi 1752-1947-1-13 Accepted 30 April 2007 This article is available from http content 1 1 13 2007 Cormack and Kaufman licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Thrombocytopenia commonly occurs in hospitalized patients particularly critically ill patients. We present an exemplifying case of severe heparin-induced thrombocytopenia HIT in an effort to solidify its high priority in the differential diagnosis of thrombocytopenia. A 75-year-old female underwent cardiac surgery with intraaortic balloon pump IABP placement. A platelet count drop to 25 X 10 9 L by the third postoperative day was attributed to the IABP which was removed. Her thrombocytopenia remained refractory to multiple platelet transfusions over several days. Right hand cyanosis then developed attributed to a right radial arterial catheter which was removed. All toes and fingers then showed severe ischemic changes. Ten days after the initial platelet count drop a critical care specialist new to the treating team suspected HIT. Heparin exposure was stopped and argatroban was initiated. A HIT antibody test was subsequently strongly positive. The patients thrombocytopenia gradually resolved. No additional thromboses occurred .
