Fatal anaphylactoid reaction associated with heparin-induced thrombocytopenia

Singla, Atul; Amini, Mohammad Reza; Alpert, Martin A.; Gornik, Heather L.

doi:10.1177/1358863x13483865

Cited by 10 publications

(3 citation statements)

References 13 publications

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“…Venous thrombosis is more common (17% - 55%) than arterial thrombosis, manifesting (3% - 10%) as deep venous thromboses/pulmonary embolism, skin necrosis at the site of heparin, limb gangrene, and organ ischemia [3, 9-10]. Anaphylaxis that can be fatal has been reported [11].…”

Section: Discussionmentioning

confidence: 99%

Mesenteric Ischemia Caused by Heparin-induced Thrombocytopenia: A Case Report

Ahmed¹,

Habis²,

Samotowka³

et al. 2019

Cureus

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Deep venous thrombosis (DVT) prophylaxis is the current standard of care in trauma patients. While most of the anticoagulation complications are obvious and can be promptly identified, heparin-induced thrombocytopenia (HIT) requires a high index of suspicion for early diagnosis to prevent a potentially fatal outcome. A 39-year-old female presented to our emergency room after sustaining a gunshot wound to her left flank and pelvis requiring a sigmoid colon and left fallopian tube and ovary resection with colostomy diversion. The patient did well in her early postoperative period; however, her condition rapidly deteriorated after that as a result of mesenteric ischemia caused by heparin-induced thrombocytopenia. After multiple visits to the operating room, the patient ended up with short bowel syndrome, necessitating a referral to a bowel transplant center. Our aim is to increase awareness of this potentially lethal complication with a mortality rate up to 30% of patients.

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Section: Discussionmentioning

confidence: 99%

Mesenteric Ischemia Caused by Heparin-induced Thrombocytopenia: A Case Report

Ahmed¹,

Habis²,

Samotowka³

et al. 2019

Cureus

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“…There have been some cases reported in the literature that patients with heparin exposure who developed thrombocytopenia and signs of thrombosis (such as non-necrotising lesions at the site of subcutaneous injection of UFH or LMWH) developed anaphylactoid reactions with subsequent heparin exposure 11 13. However, either due to lack of documentation or lack of recognition of these clinical signs (skin lesions), as related to HIT, these patients received repeated exposure to heparin.…”

Section: Discussionmentioning

confidence: 99%

Early recognition is the key to success: pulseless electrical activity (PEA) as a manifestation of heparin-induced anaphylactoid reaction

Jayarangaiah¹,

Epperla

2015

BMJ Case Reports

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A 64-year-old man underwent mitral valve replacement. He was hospitalised 9 days later because of slurring of speech and left-sided facial weakness. During hospitalisation, unfractionated heparin (UFH) bolus and drip were initiated due to subtherapeutic international normalised ratio. Within 5 min of UFH bolus, the patient began to experience symptoms of dyspnoea, followed by pulseless electrical activity arrest. He was successfully resuscitated. A decline in platelet count >50% was noted immediately after UFH bolus and cardiac arrest. A diagnosis of heparin-induced thrombocytopenia and anaphylactoid reaction was considered (4Ts score of 7). Heparin was discontinued and argatroban was started. A platelet factor 4 (PF4) assay was strongly positive. Platelet counts subsequently improved following discontinuation of heparin.

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“…A subset of type II HIT, rapid onset HIT, found in 25% of cases, involves the development of thrombocytopenia within 24 hours of re-exposure due to circulating antibodies from recent heparin use within the last 90 days. It is usually complicated by an anaphylactoid reaction during the 30 minutes after a heparin bolus [4]. Delay in treatment of HIT may result in a 5-10% daily risk of thrombosis, amputation, or death [5].…”

Section: Introductionmentioning

confidence: 99%

Type II Heparin-Induced Thrombocytopenia Manifesting As Cardiac Arrest Following Intravenous Heparin Bolus During an Elective Procedure: A Case Report and Literature Review

Nepal,

Patel,

Omosebi

et al. 2024

Cureus

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Heparin-induced thrombocytopenia (HIT) is a rare and life-threatening autoimmune-mediated adverse drug reaction seen in patients who are exposed to various forms of pharmacological heparin, including unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Despite the presence of thrombocytopenia, these patients face the risk of clot formation and bleeding simultaneously. Prompt cessation of heparin and the initiation of non-heparin anticoagulants are important for the patient's survival. Typically, clinical diagnosis of HIT is necessary, and waiting for lab test results, which can take days, may not be always feasible. Here, we present a case of an unusual presentation of type II HIT, complicated by significant thrombocytopenia, pulmonary hemorrhage, and cardiac arrest after receiving intravenous (IV) heparin bolus during an elective cardiac ablation procedure for paroxysmal atrial fibrillation.

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Fatal anaphylactoid reaction associated with heparin-induced thrombocytopenia

Cited by 10 publications

References 13 publications

Mesenteric Ischemia Caused by Heparin-induced Thrombocytopenia: A Case Report

Mesenteric Ischemia Caused by Heparin-induced Thrombocytopenia: A Case Report

Early recognition is the key to success: pulseless electrical activity (PEA) as a manifestation of heparin-induced anaphylactoid reaction

Type II Heparin-Induced Thrombocytopenia Manifesting As Cardiac Arrest Following Intravenous Heparin Bolus During an Elective Procedure: A Case Report and Literature Review

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