Anticoagulation with a selective thrombin inhibitor in a woman with heparin-induced thrombocytopenia.
BACKGROUND
Heparin-induced thrombocytopenia is an immunologic complication of heparin therapy with potentially serious venous and arterial thrombotic sequelae. Progression to overt thrombosis is the most serious complication, occurring in approximately 0.5% of heparin-treated patients. Previous strategies for treatment of the associated thrombosis with heparin-induced thrombocytopenia have frustrated clinicians with poor outcomes.


METHODS
A 45-year-old woman with stage IB endometrial cancer underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. She suffered a pulmonary embolism postoperatively. The pulmonary embolism was treated with heparin, and heparin-induced thrombocytopenia and central vein catheter-related thrombosis developed. She underwent thrombectomy and was successfully anticoagulated with a selective thrombin inhibitor instead of heparin.


CONCLUSIONS
This treatment should be considered for patients with heparin-induced thrombocytopenia in either a prophylactic or a treatment regimen.
Aida
H
H
Department of Obstetrics and Gynecology, Niigata University Faculty of Medicine, Niigata, Japan.
Aoki
Y
Y
Ohki
I
I
Tanaka
K
K
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives; D002405:Catheterization, Central Venous; D005260:Female; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D010875:Pipecolic Acids / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000628:therapy; D013449:Sulfonamides; D017131:Thrombectomy; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D013927:Thrombosis / Q000628:therapy
D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban