title: [Two cases of heparin-induced thrombocytopenia (HIT) and a review of the literature].
abstract: We experienced two cases of heparin-induced thrombocytopenia (HIT) which occurred during unfractionated heparin treatment. The first patient was a 72-year-old man, who was admitted to our hospital because of sudden onset dyspnea in January 2000. He was diagnosed as having a pulmonary embolism and heparin was started. Nine days later, progressive embolization of the pulmonary artery and femoral vein was found and thrombocytopenia (platelet count 20 x 10(9)/l) was observed 14 days after that. Cessation of heparin and administration of argatroban resulted in progressive normalization of the platelet count. The second patient was a 62-year-old woman, who was admitted to our hospital in April 2001, with the chief complaint of sudden onset dyspnea. She was diagnosed as having acute left-sided heart failure and heparin was started. Fifteen 15 days later, thrombocytopenia (platelet count 17 x 10(9)/l) was observed. Cessation of heparin resulted in normalization of the platelet count. Both cases were positive for anti-heparin-platelet factor 4 (PF4) antibody. Here we report on the clinical course of two cases of HIT with a review of the literature.
authors.affiliation: Uwajima City Hospital.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaneko
authors.forename: Hisaharu
authors.initials: H
authors.lastname: Shikata
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Kohno
authors.forename: Masatake
authors.initials: M
authors.lastname: Muraoka
mesh_terms: D000368:Aged; D000906:Antibodies / Q000097:blood; D001120:Arginine / Q000031:analogs & derivatives; D005260:Female; D006333:Heart Failure / Q000188:drug therapy; D006493:Heparin / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010875:Pipecolic Acids / Q000627:therapeutic use; D010978:Platelet Factor 4 / Q000276:immunology; D011655:Pulmonary Embolism / Q000188:drug therapy; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000906:Antibodies; D010875:Pipecolic Acids; D013449:Sulfonamides; D010978:Platelet Factor 4; D014859:Warfarin; D006493:Heparin; D001120:Arginine; C031942:argatroban