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.
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Heather
H
Magnan
Mark L
ML
Kayton
Donna M
DM
DiMichele
David J
DJ
Araten
Nancy A
NA
Kernan
Farid
F
Boulad
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