Treatment of refractory delayed onset heparin-induced thrombocytopenia after thoracic endovascular aortic repair with intravenous immunoglobulin (IVIG).
Citation: Research And Practice In Thrombosis And Haemostasis. 1(1):134-137, 2017 Jul.PMID: 30046682Institution: MedStar Washington Hospital CenterDepartment: Hematology/Oncology | Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Case ReportsYear: 2017ISSN:- 2475-0379
Delayed onset heparin induced thrombocytopenia (HIT), is characterized by a late nadir due to persistent platelet-activating IgG antibodies. It typically begins or worsens 5 or more days after heparin is discontinued with complications such as thrombosis up to 3 weeks after exposure to heparin.1-3 In 50% of cases, the platelet count can decrease to very low numbers (<20 000/muL), which is not usual for typical HIT. Here we report 2 cases of post-operative delayed onset HIT manifesting as severe thrombocytopenia that persisted despite cessation of heparin and initiation of argatroban. Key Clinical Question: Is intravenous immunoglulin beneficial in severe refractory delayed-onset HIT?
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