Lepirudin treatment in a girl with iliac vein thrombosis, severe pulmonary embolism and suspected heparin-induced thrombocytopenia (HIT) II.
We report on a 15-year-old girl referred to us for dyspnea. Investigations revealed multiple pulmonary emboli originating from iliac vein thrombosis. As under heparin therapy, d-dimers rose again and the thrombus grew significantly in size while platelet count decreased by >30%. A diagnosis of heparin-induced thrombocytopenia (HIT) type II was suspected, heparin-treatment was stopped and lepirudin therapy was started successfully at a doses of 0.15 mg/kg bw/hr.
Klinik I, Zentrum für Kinder- und Jugendmedizin, Freiburg. kerstin.walter@uniklinik-freiburg.de
K N
KN
Walter
M
M
Erlacher
M
M
Uhl
U
U
Budde
G
G
Nowak
A
A
Superti-Furga
B
B
Zieger
D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006629:Hirudins; D006801:Humans; D007084:Iliac Vein; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D013921:Thrombocytopenia / Q000139:chemically induced*; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D014682:Vena Cava, Inferior
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin