[Heparin-induced thrombocytopenia type II with thrombosis in an intensive care patient: therapy management using the direct thrombin inhibitor argatroban].
Heparin-induced thrombocytopenia (HIT) type II is a life-threatening complication of heparin therapy. The present case report describes the therapeutic management of HIT type II with thrombosis using the direct thrombin inhibitor argatroban in an intensive care patient after successful surgery of a ruptured infrarenal abdominal aortic aneurysm. Despite high dosing and long-term application of argatroban, anticoagulation remained uncritical and was well controllable by monitoring the activated partial thromboplastin time. In consideration of the pharmacological characteristics, therapy suspension due to invasive interventions and switching to an oral vitamin K antagonist by defined algorithm resulted in an effective management.
Heil
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Abteilung für Anästhesie und Intensivmedizin, Wilhelminenspital, Montleartstrasse 37, 1160, Wien, Osterreich. sabine.heil@wienkav.at
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D001120:Arginine / Q000031:analogs & derivatives; D005076:Exanthema / Q000150:complications / Q000188:drug therapy; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010314:Partial Thromboplastin Time; D010875:Pipecolic Acids / Q000627:therapeutic use*; D010976:Platelet Count; D013449:Sulfonamides; D013917:Thrombin / Q000037:antagonists & inhibitors*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy*; D013927:Thrombosis / Q000097:blood / Q000150:complications*
D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; D013917:Thrombin; C031942:argatroban