Tackling the devastating effects of heparin-induced thrombocytopenia.
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.
Abraham
Prasad
P
Grady Health System, Atlanta, GA, USA.
Uber
Walter E
WE
Lazarchick
John
J
Crumbley
Arthur J
AJ
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
D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin