Persisting heparin-induced thrombocytopenia (HIT) is characterized by ongoing thrombocytopenia more than 7 days after stopping heparin. It is part of cases referred to as autoimmune HIT (aHIT). In contrast to typical HIT cases, aHIT involves heparin-independent platelet activation mechanism highlighted by a strongly positive functional assay done without heparin. We report the first case of persisting HIT after an elective abdominal aortic aneurysm repair presenting with arterial and venous thrombosis, and describe the potential role of intravenous immunoglobulin in such patients.
Keywords Case report • Heparin • Thrombocytopenia • Thrombosis • Immunoglobulin
Highlights• Ongoing thrombocytopenia more than 7 days after stopping heparin and new thrombosis despite receiving treatment characterize persisting HIT. • Autoimmune HIT is characterized by a strongly positive functional assay done without heparin. • Intravenous immunoglobulin for treatment of autoimmune HIT results in improvement of thrombocytopenia and the most used dosing schedule is 1 g/kg daily for 2 doses.• Intravenous immunoglobulin should be considered as an emerging therapy for autoimmune HIT.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.