Korean J Anesthesiol.  2006 May;50(5):600-604. 10.4097/kjae.2006.50.5.600.

Heparin-Induced Thrombocytopenia during Continuous Veno-Venous Hemodiafiltration after Total Aortic Arch Replacement: A case report

• Jeong HJ
• Kim JK
• Choi JY
• Yoon SZ
• Jeon YS
• Park KU
• Bahk JH
• Ahn H
• Kim CS
• Kim YL

• KMID: 2092100
• DOI: http://doi.org/10.4097/kjae.2006.50.5.600

Abstract

Heparin-induced thrombocytopenia (HIT) is an immunologically mediated complication of heparin therapy resulting in the consumption of platelets and a catastrophic thromboembolism. Both the clinical and laboratory features are important for a diagnosis of HIT. There have been 3 case reports of suspected HIT in Korea. However none have satisfied the laboratory features. We experienced a case of HIT, which satisfied both clinical and laboratory features, in a patient who received heparin during continuous veno-venous hemodiafiltration (CVVHD) used to treat acute renal failure that developed after a total aortic arch replacement with a cardiopulmonary bypass. The decreased platelet count and obstruction of extracorporeal filter of CVVHD by the blood clot was observed while receiving unfractionated heparin. The serum from the patient contained the anti heparin-platelet factor 4 antibody, and the condition was thus diagnosed as HIT. Argatroban, which is a direct thrombin inhibitor, was used to treat the thrombosis.

Keyword

anti heparin-PF4 antibody; argatroban; heparin; thrombocytopenia; thromboembolism

MeSH Terms

Acute Kidney Injury
Aorta, Thoracic*
Cardiopulmonary Bypass
Diagnosis
Hemodiafiltration*
Heparin
Humans
Korea
Platelet Count
Thrombin
Thrombocytopenia*
Thromboembolism
Thrombosis
Heparin
Thrombin