Pulmonary embolism after cesarian section due to heparin-induced thrombocytopenia despite normal platelet count.
Heparin-induced thrombocytopenia (HIT) type II is typically characterized by a decrease in platelet count to values between 20 and 120 x 10 (9)/L or a platelet count fall of greater than 50%. We report on a patient who developed a HIT syndrome, thrombosis of the vena cava, and fulminant pulmonary embolism during heparin treatment after cesarean section, without a significant decrease in platelet count. Lepirudin anticoagulation and ecarin clotting time (ECT) monitoring were used successfully during cardiopulmonary bypass.
Riess
F-C
FC
Department of Cardiac Surgery, Albertinen Hospital, Hamburg, Germany. Friedrich-Christian.Riess@albertinen.de
Gross
A
A
Budde
U
U
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002315:Cardiopulmonary Bypass / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006629:Hirudins / Q000009:adverse effects*; D006801:Humans; D010976:Platelet Count; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012016:Reference Values; D018570:Risk Assessment; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; C083544:lepirudin