Catastrophic heparin-induced thrombocytopenia/thrombosis syndrome related to the use of a Port-A-Cath in a breast cancer patient receiving chemotherapy.
Heparin-induced thrombocytopenia and thrombosis (HIT/T) syndrome is usually triggered by an immune response after repeated administration of heparin. The syndrome is strongly associated with limb deep vein thrombosis and is potentially life-threatening if unrecognized. We describe the case of a patient with compartment syndrome of the left forearm complicated by HIT/T that developed after Port-A-Cath implantation through the left subclavian vein. Prompt recognition of HIT/T, immediate withdrawal of heparin, and timely institution of thrombolytic therapy successfully prevented limb loss.
Dai
Ming-Shen
MS
Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325 Cheng-Kung Road, Section 2, Neihu 114, Taipei, Taiwan.
Hsieh
An-Tie
AT
Chao
Tsu-Yi
TY
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000601:surgery; D002405:Catheterization, Central Venous; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D013927:Thrombosis / Q000139:chemically induced* / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin