title: Anticoagulant-induced pseudothrombocytopenia occurring after transcatheter arterial embolization for hepatocellular carcinoma.
abstract: 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.
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan. yoshikaw@med.kobe-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Kayo
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Maruta
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takenaka
authors.forename: Shozo
authors.initials: S
authors.lastname: Hirota
authors.forename: Shinichi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Katsuyasu
authors.initials: K
authors.lastname: Saigo
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ohno
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujii
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: 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
chemical_list: D000903:Antibiotics, Antineoplastic; D000925:Anticoagulants; D015251:Epirubicin; D004492:Edetic Acid