[Patient with heparin-induced thrombocytopenia type II and implanted left ventricular assist device].
The administration of heparin can lead to life-threatening heparin-induced thrombocytopenia (HIT) type II, which is caused by antibodies against heparin-platelet factor 4-complexes. The multimorbid patient presented here suffered from HIT II. Preoperative and postoperative prevention of thrombosis was successfully conducted with argatroban and the management of anticoagulation is presented. During therapy with argatroban, discrepancies in the partial thromboplastin time (PTT) and the international normalized ratio (INR) appeared sporadically. The clinical causes for these differences remain unclear.
Lutz
J T
JT
Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, St. Vinzenz-Hospital, Akademisches Lehrkrankenhaus Universität Köln, Merheimer Strasse 221-223, 50733 Köln, Deutschland. juergen.lutz@vinzenz-hospital.de
Exner
H J
HJ
Schannewitzky
A
A
Fehske
W
W
Görlinger
K
K
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D001120:Arginine / Q000031:analogs & derivatives; D005260:Female; D006353:Heart-Assist Devices; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D010314:Partial Thromboplastin Time; D010875:Pipecolic Acids / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010978:Platelet Factor 4 / Q000276:immunology; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications* / Q000517:prevention & control
D000925:Anticoagulants; D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D010978:Platelet Factor 4; D006493:Heparin; D001120:Arginine; C031942:argatroban