title: Fatal bleeding due to a heparin-like anticoagulant in a 37-year-old woman suffering from systemic mastocytosis.
abstract: 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.
authors.affiliation: Department of Hemostasis and Transfusion Medicine, Heinrich Heine University Medical Center, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Sucker
authors.forename: Georg
authors.initials: G
authors.lastname: Mansmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Steiner
authors.forename: Norbert
authors.initials: N
authors.lastname: Gattermann
authors.forename: Anette
authors.initials: A
authors.lastname: Schmitt-Graeff
authors.forename: Robert
authors.initials: R
authors.lastname: Loncar
authors.forename: Rudiger E
authors.initials: RE
authors.lastname: Scharf
authors.forename: Marcus
authors.initials: M
authors.lastname: Stockschlader
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D006493:Heparin