Thrombocytopenia, antithrombin deficiency and extensive thromboembolism in pregnancy: treatment with low-molecular-weight heparin.
Pregnancy limits the therapeutic options for managing thrombocytopenia which occurs in 5% of patients on heparin. We describe a case of extensive thromboembolism associated with antithrombin (AT) deficiency complicated by thrombocytopenia which resolved when low-molecular-weight heparin was instituted. A primigravid woman presented at 11 weeks gestation with bilateral femoral occlusive thrombi extending above the renal veins. Investigations revealed AT deficiency, thrombocytopenia and renal infarction. After low-molecular-weight heparin was substituted for unfractionated heparin, the thrombocytopenia resolved and although the pregnancy was lost, the patient made a full recovery.
Macklon
N S
NS
University Department of Obstetrics and Gynaecology, Glasgow Royal Infirmary, UK.
Greer
I A
IA
Reid
A W
AW
Walker
I D
ID
D000328:Adult; D000990:Antithrombin III / Q000627:therapeutic use; D020152:Antithrombin III Deficiency; D017984:Enoxaparin / Q000627:therapeutic use*; D005260:Female; D005313:Fetal Death; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000209:etiology*; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology*
D017984:Enoxaparin; D000990:Antithrombin III; D006493:Heparin