[Thrombocytopenia and disseminated intravascular coagulation in low-dose heparin prophylaxis].
During postoperative prophylaxis of thrombosis using subcutaneous low-dose heparin thrombocytopenia and consumption coagulopathy without manifest haemorrhage were observed in a female patient with gynaecologic problems on the tenth postoperative day. Using gel-electrophoresis, demonstration of cross-linked fibrin derivatives, which occur only after contact with thrombin, was proof that disseminated intravascular coagulation must have been present. Cancellation of heparin prophylaxis was sufficient for regression of the haemostatic disorder. Platelet function tests performed two months later showed as the only reproducible abnormality that the patient's plasma caused inhibition of desaggregation of normal platelets only when heparin was present. The remarkably close chronologic connection of heparin prophylaxis with thrombocytopenia and consumption coagulopathy suggests a possible causal connection. However, at present the possibly heterogeneous aetiology cannot be explained satisfactorily.
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007044:Hysterectomy; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000503:physiopathology
D006493:Heparin
Thrombozytopenie und disseminierte intravasale Gerinnung bei niedrig dosierter Heparinprophylaxe.