Anticoagulant-induced pseudothrombocytopenia occurring after transcatheter arterial embolization for hepatocellular carcinoma.
Pseudothrombocytopenia (PTCP) is the in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts. We report the case of a 65-year-old man with EDTA- and sodium citrate-dependent PTCP occurring after transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) due to hepatitis C cirrhosis. Invasion of the portal and hepatic veins by HCC formed severe trans-tumoral arterio-venous shunts that were effectively treated by TAE. Two days after the therapy, PTCP was seen on blood count and continued for 4 months. The patient received unnecessary treatment for disseminated intravascular coagulation (DIC) until the diagnosis of PTCP was established. PTCP is a rare complication but should be considered after TAE for HCC; lack of recognition may lead the physician to misdiagnosis and patient mismanagement.
Yoshikawa
Takeshi
T
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan. yoshikaw@med.kobe-u.ac.jp
Nakanishi
Kayo
K
Maruta
Tsutomu
T
Takenaka
Daisuke
D
Hirota
Shozo
S
Matsumoto
Shinichi
S
Saigo
Katsuyasu
K
Ohno
Yoshiharu
Y
Fujii
Masahiko
M
Sugimura
Kazuro
K
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000925:Anticoagulants / Q000009:adverse effects*; D001792:Blood Platelets / Q000187:drug effects; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000628:therapy*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis; D004492:Edetic Acid / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D015251:Epirubicin / Q000008:administration & dosage; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008297:Male; D009361:Neoplasm Invasiveness; D010976:Platelet Count; D011169:Portal Vein / Q000473:pathology; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000209:etiology
D000903:Antibiotics, Antineoplastic; D000925:Anticoagulants; D015251:Epirubicin; D004492:Edetic Acid