title: Tackling the devastating effects of heparin-induced thrombocytopenia.
abstract: Heparin-induced thrombocytopenia with associated thrombosis is a potentially catastrophic complication of heparin therapy. Heart failure patients often require heparin therapy in the setting of multiple comorbidities, particularly renal insufficiency. The authors report a case of heparin-induced thrombocytopenia with associated thrombosis in a patient with multisystem organ failure and discuss dosing regimens using lepirudin for the treatment of this disorder. The potential risk for excessive anticoagulation is highlighted and a conservative dosing strategy with frequent monitoring of this agent in the presence of renal failure is emphasized.
authors.affiliation: Grady Health System, Atlanta, GA, USA.
authors.forename: Prasad
authors.initials: P
authors.lastname: Abraham
authors.forename: Walter E
authors.initials: WE
authors.lastname: Uber
authors.forename: John
authors.initials: J
authors.lastname: Lazarchick
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Crumbley
mesh_terms: D000208:Acute Disease; D000925:Anticoagulants / Q000009:adverse effects*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008875:Middle Aged; D011994:Recombinant Proteins / Q000009:adverse effects; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced*; D017211:Treatment Failure
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin