title: Acute myocardial infarction caused by delayed heparin-induced thrombocytopenia and acute immunoreaction due to re-exposure to heparin in a systemic lupus erythematosus patient with HIT antibodies.
abstract: A patient with systemic lupus erythematosus and anticardiolipin antibodies and antibodies to platelet factor 4/heparin complexes suffered an acute myocardial infarction caused by delayed heparin-induced thrombocytopenia after heparin administration given to treat pulmonary hypertension. Furthermore, additional heparin administration for emergency coronary angiography appeared to have led to an acute immunoreaction, which might have resulted in acute coronary occlusion during coronary angiography and to a decreased platelet count. The present findings suggest that one must suspect delayed-type HIT in rare cases of induction of thrombosis after the cessation of heparin treatment, and avoid re-exposure to heparin in such cases.
authors.affiliation: Department of Internal Medicine, Hyogo Prefectural Awaji Hospital, Sumoto, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Takeaki
authors.initials: T
authors.lastname: Okada
authors.forename: Miyako
authors.initials: M
authors.lastname: Matsuo
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saitoh
authors.forename: Takefumi
authors.initials: T
authors.lastname: Matsuo
mesh_terms: D001323:Autoantibodies / Q000097:blood; D004342:Drug Hypersensitivity / Q000150:complications*; D005260:Female; D006493:Heparin / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000188:drug therapy; D007109:Immunity; D008180:Lupus Erythematosus, Systemic / Q000097:blood; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D006493:Heparin