Splenic infarction and subsequent splenic rupture in a patient with paroxysmal nocturnal hemoglobinuria and heparin-induced thrombocytopenia.
We describe a patient with paroxysmal nocturnal hemoglobinuria (PNH) and no previous history of thrombosis who presented with hepatic venous thromboses and subsequently developed splenic infarction and rupture requiring splenectomy while on anticoagulation therapy for the hepatic thromboses. The patient's anticoagulation was complicated by heparin-induced thrombocytopenia (HIT) highlighting the unique management challenge presented by PNH in combination with HIT.
Magnan
Heather
H
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Kayton
Mark L
ML
DiMichele
Donna M
DM
Araten
David J
DJ
Kernan
Nancy A
NA
Boulad
Farid
F
D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D013159:Splenic Infarction / Q000209:etiology*; D013161:Splenic Rupture / Q000209:etiology*; D013921:Thrombocytopenia / Q000150:complications*
D000925:Anticoagulants; D006493:Heparin