title: Heparin-associated thrombocytopenia and thrombosis as the cause of a fatal thrombus on extracorporeal membrane oxygenation.
abstract: A rare state of acquired hypercoagulability known as heparin-associated or heparin-induced thrombocytopenia and thrombosis (HATT, HITT) exists. It appears to be caused by an antibody reaction with heparin-platelet factor 4 complexes. A mild and severe form exist, but both varieties occur after exposure to heparin. The authors describe a fatal neonatal case of hypercoagulability on extracorporeal membrane oxygenation, and their evaluation that determined the etiology as type II HATT. They discuss the pathophysiology of HATT as well as possible alternative anticoagulation approaches.
authors.affiliation: Department of Neonatology, Wilford Hall Medical Center, Lackland AFB, San Antonio, TX, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Butler
authors.forename: L J
authors.initials: LJ
authors.lastname: Sodoma
authors.forename: J J
authors.initials: JJ
authors.lastname: Doski
authors.forename: H W
authors.initials: HW
authors.lastname: Cheu
authors.forename: S T
authors.initials: ST
authors.lastname: Berg
authors.forename: G N
authors.initials: GN
authors.lastname: Stokes
authors.forename: K J
authors.initials: KJ
authors.lastname: Lancaster
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000139:chemically induced*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D017809:Fatal Outcome; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants; D006493:Heparin