title: [Thrombotic microangiopathy mimicking a heparin-induced thrombocytopenia].
abstract: We report a case of a 47 years old woman. In her case of medical history, there were vein thrombosis and an allergic to tinzaparin. The patient entered in critical care unit under medical supervision for a multivisceral infarction due to an arterial mesenteric, renal and splenic thrombosis. An heparinotherapy was introduced. A laparotomy was realized because of an occlusion. Small intestine necrozed was removed. 8 days after the introduction of the heparin, there was a thrombocytopenia. Considering the background and the initiale situation, an heparin-induced thrombocytopenia of type II (HTI) was suspected. Whereas the heparinotherapy was stopped, the thrombocytopenia maked worse. Biological tests infirmed HIT's diagnosis. A recurrent anemia in spite transfusions associated to a renal failure suggest a thrombotic microangiopathy which was secondary confirmed. The intensivist is sensibilized to evoke an heparin induced thrombocytopenia when there is a thrombocytopenia under heparin. However, he must not forget diagnosis of thrombocytopenia which required specific investigations and emergency treatment such as thrombotic microangiopathy.
authors: Fédération d'anesthésie-réanimation et des urgences, HIA Clermont Tonnerre, BCRM de Brest, France. sophiehuynh@gmail.com
authors: Sophie
authors: S
authors: Huynh-Moynot
authors: Sandrine
authors: S
authors: Eyrieux
authors: Jean-Clair
authors: JC
authors: Moynot
authors: Diane
authors: D
authors: Commandeur
authors: Didier
authors: D
authors: Fourel
authors: Mehdi
authors: M
authors: Ould-Ahmed
authors: Isabelle
authors: I
authors: Drouillard
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006405:Hematology / Q000379:methods; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis*; D057049:Thrombotic Microangiopathies / Q000175:diagnosis*
chemical_list: D006493:Heparin
keywords: haemolytic uraemic syndrome; heparin; heparin induced thrombocytopenia; thrombotic microangiopathies; thrombotic thrombocytopenic purpura