title: Chronic fondaparinux use in a hemodialysis patient with heparin-induced thrombocytopenia type II and extracorporeal circuit thrombosis-a case report and review of the literature.
abstract: Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening condition that can develop after exposure to unfractionated or low-molecular-weight heparins. Treatment options appear to be limited in patients on concurrent intermittent hemodialysis. We report the case of an 88-year-old man newly initiated on high-flux hemodialysis who developed HIT and extracorporeal circuit thrombosis after 3 weeks of exposure to unfractionated heparin. Our patient was successfully treated with fondaparinux 2.5 mg subcutaneously three times per week and citrate during dialysis sessions. Antifactor Xa levels were measured on several occasions while receiving fondaparinux.
authors.affiliation: Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. paula.brown@sunnybrook.ca
authors.forename: Paula
authors.initials: P
authors.lastname: Brown
authors.forename: Richard
authors.initials: R
authors.lastname: Jay
authors.forename: Andrea
authors.initials: A
authors.lastname: Fox
authors.forename: Matthew
authors.initials: M
authors.lastname: Oliver
mesh_terms: D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011134:Polysaccharides / Q000627:therapeutic use*; D006435:Renal Dialysis; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*; D013927:Thrombosis / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D000077425:Fondaparinux