Severe thrombocytopenia after heparin therapy in a patient with unstable angina and recent stent implantation.
Heparin-induced thrombocytopenia represents a serious side effect of heparin therapy. Immune-mediated platelet activation results in thrombocytopenia, endothelial thrombin release and development of thrombosis, mainly venous. We report the case of a man with a history of coronary artery disease and recent stent implantation. This patient developed severe heparin-induced thrombocytopenia type II after low molecular weight heparin administration because of unstable angina which occurred two months after stent implantation. The patient was treated with a new anticoagulant regimen, fondaparinux sodium. There were no complications and platelet counts were restored to normal levels.
Department of Cardiology, General Hospital of Karditsa, Greece. skevos1@otenet.gr
Skevos K
SK
Sideris
Michael J
MJ
Bonios
Eftihios E
EE
Eftihiadis
Christina A
CA
Melexopoulou
Tereza A
TA
Mousiama
Kostas T
KT
Diplaris
John S
JS
Kogias
D000789:Angina, Unstable / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004562:Electrocardiography; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D000077425:Fondaparinux; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects; D010976:Platelet Count; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use; D015607:Stents; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy
D000925:Anticoagulants; D017984:Enoxaparin; D011134:Polysaccharides; D000077425:Fondaparinux