Catastrophic Complications of Intravenous Line Flushing with Unfractionated Heparin

• 作者: Giuseppe Colucci Lorenzo Alberio Maximilian Jahns Tobias Silzle
• 来源期刊: 临床医学国际期刊(英文)
• 学科: 医学
• 关键词: Heparin-Induced THROMBOCYTOPENIA Adrenal Haemorrhagic Necrosis 4T Score PF4/Heparin-Antibodies
• 年，卷（期）: 2012,（1）
• 页码范围: 36-39
• 页数: 4页
• 分类号: R5

摘要

Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome because diagnosis is based on both clinical symptoms and laboratory data. We report a patient with multiple thromboembolic complications after daily flushing of intravenous line with small amounts of unfractionated heparin (UFH). At day 7 bilateral hemorrhagic infarction of the adrenal glands was misdiagnosed as adrenal adenoma. On day 10 thrombocytopenia was noted and the next day a myocardial infarction complicated by a left ventricular thrombus was diagnosed. On day 12, HIT was suspected. The pre-test probability for HIT according to the 4T-score was high (8/8 points) and detection of antibodies directed against the PF4/heparin-complex by particle gel immunoassay (Titer 1:1024) and ELISA (O.D. 2.784) was strongly positive. HIT can be induced by iv-line flushes with UFH. Arterial and venous thrombotic complications can be present before a clear platelet drop can be recognised.