title: Heparin-induced thrombocytopenia with pulmonary embolism and disseminated intravascular coagulation associated with low-molecular-weight heparin.
abstract: Heparin-induced thrombocytopenia (HIT) is a severe adverse effect of heparin therapy. Although most cases occur in patients receiving unfractionated heparin, HIT can arise in venous thrombosis prophylaxis with a low-molecular-weight heparin (LMWH). We report an uncommon case of HIT in a postoperative orthopedic patient associated with LMWH (nadroparin), complicated by deep venous thrombosis, pulmonary embolism, and disseminated intravascular coagulation, treated successfully with recombinant hirudin and immunoglobulin therapy.
authors.affiliation: Intensive Care Unit, Hippokration General Hospital, Athens, Greece. abetrosian@netscape.net
authors.forename: Alex P
authors.initials: AP
authors.lastname: Betrosian
authors.forename: George
authors.initials: G
authors.lastname: Theodossiades
authors.forename: George
authors.initials: G
authors.lastname: Lambroulis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kostantonis
authors.forename: Margarita
authors.initials: M
authors.lastname: Balla
authors.forename: Metaxia
authors.initials: M
authors.lastname: Papanikolaou
authors.forename: George
authors.initials: G
authors.lastname: Georgiades
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008875:Middle Aged; D017762:Nadroparin / Q000009:adverse effects* / Q000276:immunology; D015539:Platelet Activation; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000276:immunology; D013927:Thrombosis / Q000517:prevention & control; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology
chemical_list: D007074:Immunoglobulin G; D017762:Nadroparin