Heparin-induced thrombocytopenia with multiple cerebral infarctions simulating thrombotic thrombocytopenic purpura. A case report.
The authors describe a patient with stroke, treated with heparin for unstable angina, whose clinical features mimicked those of thrombotic thrombocytopenic purpura (TTP). His condition eventually proved to be caused by heparin-induced thrombocytopenia (HIT), complicated by thrombosis (HITT). The absence of microangiopathic hemolytic anemia should question the diagnosis in a presumed TTP patient. Early diagnosis of HITT is possible since recently two highly sensitive and specific tests have become available. Heparin treatment has to be stopped immediately if HITT is diagnosed. First-choice antithrombotic treatment in HITT patients is danaparoid.
Boon
D M
DM
Department of Hematology, University Hospital Dijkzigt, Rotterdam, the Netherlands.
Michiels
J J
JJ
Tanghe
H L
HL
Kappers-Klunne
M C
MC
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000150:complications*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D006493:Heparin