Heparin-induced thrombocytopenia with arterial thrombosis: an unusual case.
A case of heparin-induced thrombocytopenia with thrombosis (HITT) is described. The patient, treated for several days with porcine Ca-heparin at a dosage of 10,000 IU/day, presented severe thrombocytopenia (Plt 36 x 10(9)/L), intermittent right leg ischemia, and a positive heparin-induced platelet aggregation assay. We promptly discontinued heparin and started picotamide, an antiplatelet drug. Rapid clinical improvement was observed in a few days. We stress the unusual features of the reported case (HITT during prophylactic therapy with low doses of porcine heparin; intermittent thrombosis), and we suggest picotamide represents a rational therapy for HITT on the basis of clinical and pathogenetic considerations.
Di Natale
M
M
1 Divisione di Medicina Interna, Ospedale di Prato, Italy.
Fiusti
R
R
Grassi
M
M
Lai
F
F
Corradi
F
F
D004359:Drug Therapy, Combination; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010795:Phthalic Acids / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced*; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy*
D010795:Phthalic Acids; D010975:Platelet Aggregation Inhibitors; C011581:picotamide; D006493:Heparin