Fatal bleeding due to a heparin-like anticoagulant in a 37-year-old woman suffering from systemic mastocytosis.
A 37-year-old female patient with systemic mastocytosis who was admitted with severe unexplained bleeding symptoms is studied. Laboratory procedures established the diagnosis of a patient-derived-heparin-like anticoagulant as a very rare hemostatic abnormality predisposing to bleeding. The patient died from refractory disease despite therapy with protamine, initiation of chemotherapy, and supportive measures. The case illustrates the clinical presentation and diagnosis of heparin-like anticoagulants. Etiology, pathophysiology, and therapeutic options are discussed.
Sucker
Christoph
C
Department of Hemostasis and Transfusion Medicine, Heinrich Heine University Medical Center, Germany.
Mansmann
Georg
G
Steiner
Stefan
S
Gattermann
Norbert
N
Schmitt-Graeff
Anette
A
Loncar
Robert
R
Scharf
Rudiger E
RE
Stockschlader
Marcus
M
D000328:Adult; D000925:Anticoagulants / Q000097:blood*; D001853:Bone Marrow / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006470:Hemorrhage / Q000097:blood* / Q000209:etiology*; D006493:Heparin / Q000097:blood*; D006801:Humans; D008407:Mast Cells / Q000473:pathology; D034721:Mastocytosis, Systemic / Q000097:blood* / Q000150:complications* / Q000473:pathology
D000925:Anticoagulants; D006493:Heparin