Heparin-induced thrombocytopenia: acknowledging its presence in low-molecular weight heparin therapy.
Low-molecular weight heparin (LMWH) is associated with a lower incidence of heparin-induced thrombocytopenia (HIT) than is unfractionated heparin. We describe a 75-year-old woman who developed HIT with thrombotic manifestations following the use of nadroparin calcium. Subsequent anticoagulation was achieved with warfarin. This case serves to highlight an important complication that cannot be ignored despite its low incidence. The majority of HIT cases are likely to occur in LMWH-treated patients because LMWH replaces unfractionated heparin for most indications. The lack of suitable alternative anticoagulant treatments for patients with HIT in Singapore is also emphasized.
Ng
Heng Joo
HJ
Department of Haematology, Singapore General Hospital, Singapore, Republic of Singapore. ghenhj@sgh.com.sg
Lee
Lai Heng
LH
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D017762:Nadroparin / Q000009:adverse effects / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced*; D013997:Time Factors; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D017762:Nadroparin; D014859:Warfarin