title: Heparin-associated thrombocytopenia and thrombosis syndrome in a rehabilitation patient.
abstract: Heparin-associated thrombocytopenia and thrombosis (HATT) syndrome is a severe complication of heparin therapy. Since patients admitted for rehabilitation are at high risk for deep-vein thrombosis and pulmonary embolism, prophylactic doses of subcutaneous heparin are frequently used. We report the case of a 73-year-old woman with a history of heparin exposure, admitted to a comprehensive rehabilitation program for management of severe back pain. The patient was started on subcutaneous heparin. After 18 days of hospitalization, she developed marked thrombocytopenia and a massive venous thrombosis in the right lower extremity. On intravenous heparin therapy, the platelet count continued to decline. The thrombocytopenia resolved with discontinuation of heparin. This case illustrates a devastating complication of heparin therapy and emphasizes that physiatrists should be aware of this acute and preventable drug reaction.
authors.affiliation: Albert Einstein College of Medicine/Montefiore Medical Center, Department of PM&R, Bronx, NY 10461.
authors.forename: M A
authors.initials: MA
authors.lastname: Young
authors.forename: E D
authors.initials: ED
authors.lastname: Ehrenpreis
authors.forename: M
authors.initials: M
authors.lastname: Ehrenpreis
authors.forename: S
authors.initials: S
authors.lastname: Kirshblum
mesh_terms: D000368:Aged; D001416:Back Pain / Q000534:rehabilitation*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D013921:Thrombocytopenia / Q000139:chemically induced*; D013924:Thrombophlebitis / Q000139:chemically induced*
chemical_list: D006493:Heparin