Transient global amnesia as the presenting feature of heparin-induced thrombocytopenia.
A 57-year-old man developed transient global amnesia within an hour of bolus unfractionated heparin administration on day 4 post-mitral valve replacement. Both immunoglobulin G-specific enzyme-linked immunosorbent assay and serotonin release assay were strongly positive for the antibodies that cause heparin-induced thrombocytopenia. The patient's cognitive functions returned to normal following discontinuation of unfractionated heparin and warfarin and commencement of lepirudin infusion.
Teh
Chun Huat
CH
Department of Cardiology, Royal Infirmary of Edinburgh, Scotland, United Kingdom.
Robertson
Martyn N
MN
Warkentin
Theodore E
TE
Henriksen
Peter A
PA
Brackenbury
Edward T
ET
Anderson
Julia A M
JA
D020236:Amnesia, Transient Global / Q000139:chemically induced / Q000175:diagnosis*; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D019918:Heart Valve Prosthesis Implantation; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications*; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D014859:Warfarin; D006493:Heparin; C083544:lepirudin