Heparin-induced thrombocytopenia and thrombosis (HIT/T) syndrome is usually triggered by an immune response after repeated administration of heparin. The syndrome is strongly associated with limb deep vein thrombosis and is potentially life-threatening if unrecognized. We describe the case of a patient with compartment syndrome of the left forearm complicated by HIT/T that developed after Port-A-Cath implantation through the left subclavian vein. Prompt recognition of HIT/T, immediate withdrawal of heparin, and timely institution of thrombolytic therapy successfully prevented limb loss.

A 22-year-old man was hospitalized for assessment of thrombocytopenia and fever. Examination showed that he had infectious mononucleosis and moderately severe thrombocytopenia that was asymptomatic. Examination of blood smears revealed that the thrombocytopenia was caused by the clumping of platelets. We made a diagnosis of ethylenediaminetetraacetic acid–dependent pseudothrombocytopenia after excluding other infectious mononucleosis–related mechanisms of thrombocytopenia. When the patient recovered from infectious mononucleosis 2 months later, his thrombocytopenia improved, and no platelet clumping in peripheral blood smears was noted. Ethylenediaminetetraacetic acid–dependent pseudothrombocytopenia should always be considered as a possible cause of reported low platelet counts, even in patients with infectious mononucleosis and splenomegaly.

Clinical stage is the most important factor predicting the long-term survival of patients with gastric NHL. Surgery may still be necessary in cases of failed gastroscopic diagnosis. In early-stage gastric NHL, non-surgical treatment seems able to achieve the aims of improved long-term survival and, in some instances, cure.