title: Heparin-induced thrombocytopenia as a cause of prolonged low platelet count in a patient with thrombotic thrombocytopenic purpura treated with plasmapheresis.
abstract: Thrombotic thrombocytopenic purpura (TTP) is a rare disorder belonging to thrombotic microangiopathies (TMA) and is caused by functional deficiency of the ADAMTS-13 metalloproteinase. Plasma exchange (PE) remains the treatment of choice in this disease. Here, were describe the case of a patient who apparently recovered from TTP following multiple sessions of PE, but remained thrombocytopenic. Careful analysis revealed the development of heparin-induced thrombocytopenia (HIT) that precluded platelet count (PLT) normalization. Full normalization of PLT followed discontinuation of PE and low-molecular weight heparin.
authors.affiliation: Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Winiarska
authors.affiliation: Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland.
authors.forename: Norbert
authors.initials: N
authors.lastname: Kwella
authors.affiliation: Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stompór
mesh_terms: D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000009:adverse effects*; D010976:Platelet Count; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000473:pathology / Q000628:therapy*; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced / Q000473:pathology
chemical_list: D006493:Heparin
keywords: heparin-induced thrombocytopenia; plasma exchange; thrombotic thrombocytopenic purpura