title: Heparin-induced thrombocytopenia and thrombosis in a patient with polycythemia vera.
abstract: A 75-year-old Japanese woman with polycythemia vera was admitted to our hospital in January 2003 with suspected pulmonary thromboembolism. After administration of heparin, platelet count decreased from 1,694 x 10(9)/l on admission to 60 x 10(9)/l on hospital day 14. The patient developed acute limb embolism and transient cerebral ischemic attack on days 17 and 25, respectively. Signs and symptoms mimicked those of disseminated intravascular coagulation. Antibodies against heparin and platelet factor 4 complexes were detected in serum, and a diagnosis of heparin-induced thrombocytopenia and thrombosis was made. Argatroban treatment improved thrombocytopenia and hypercoagulable state.
authors.affiliation: Division of Internal Medicine, Tokyo Metropolitan Police Hospital, Tokyo.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Suyama
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Kaneko
authors.forename: Juri
authors.initials: J
authors.lastname: Okamura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakao
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Nonaka
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomura
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007564:Japan; D010875:Pipecolic Acids / Q000008:administration & dosage*; D011087:Polycythemia Vera / Q000150:complications / Q000175:diagnosis*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D013927:Thrombosis / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban