Unusual case of venous thrombosis.
A young woman developed a line-associated deep vein thrombosis (DVT), which was treated with low molecular weight heparin (dalteparin). 8 days later, the DVT had significantly extended-in spite of therapeutic heparin levels. A diagnosis of heparin-induced thrombocytopenia and thrombosis (HITT) was considered, but the platelet count had not dropped. Nevertheless, a HITT assay was carried out which came back positive, with a repeat assay confirming the result. Dalteparin was stopped and apixaban treatment started, with symptomatic recovery over the following days and weeks.
University Hospitals of Leicester NHS Trust, Leicester, UK.
Oliver
http://orcid.org/0000-0003-4334-3567
O
Jones
University Hospitals of Leicester NHS Trust, Leicester, UK.
Richard
R
Gooding
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D010976:Platelet Count; D011720:Pyrazoles / Q000627:therapeutic use*; D011728:Pyridones / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban