title: Argatroban therapy for heparin-induced thrombocytopenia during pregnancy in a woman with hereditary antithrombin deficiency.
abstract: A 33-year-old woman developed deep venous thrombosis at 7 gestational weeks (GW). Heparin-induced thrombocytopenia was evident at 9 GW during unfractionated heparin infusion. Immediately, anticoagulation therapies together with antithrombin (AT) infusion were commenced with the use of argatroban from 9 GW, and fondaparinux was substituted for argatroban after 24 GW. The patient had hereditary AT deficiency type I determined by laboratory findings and results of genomic DNA analysis. The pregnancy ended in full-term vaginal delivery of a healthy male without adverse effects of the anticoagulation therapies. This was the first report of a pregnant woman who developed heparin-induced thrombocytopenia caused by heparin therapy for deep venous thrombosis due to AT deficiency.
authors.affiliation: Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tanimura
authors.forename: Yashuhiko
authors.initials: Y
authors.lastname: Ebina
authors.forename: Ayako
authors.initials: A
authors.lastname: Sonoyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Morita
authors.forename: Shigeki
authors.initials: S
authors.lastname: Miyata
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects*; D000991:Antithrombins / Q000032:analysis*; D001120:Arginine / Q000031:analogs & derivatives; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010875:Pipecolic Acids / Q000627:therapeutic use*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban