Fatal Cerebral Venous Sinus Thrombosis in Heparin-Induced Thrombotic Thrombocytopenia

Heparin-induced thrombocytopenia: present and future

“…Case series suggest that lower extremity deep vein thrombosis (DVT) and pulmonary embolism are the predominant thrombotic manifestations of HIT [66,67]. Upper extremity catheterassociated DVT [68] and thrombosis of other venous beds including the cerebral sinuses [69] and the bilateral adrenal veins with resultant hemorrhagic conversion and adrenal failure [70] are well-documented. Arterial thrombosis-most commonly peripheral arterial thromboembolism, ischemic stroke, and myocardial infarction-also occurs in association with HIT [71,72], as does thrombosis of vascular grafts, fistulae, and extracorporeal circuits [73,74].…”

A Case of Heparin-Induced Thrombocytopenia With Sepsis and Congestive Heart Failure-First Autopsy Report in Japan-

“…In the present case, both septic DIC and HIT-induced DIC explain the clinical findings. In either case, the white clot thrombosis [12][13][14][15] of this case was compatible with HIT plus DIC.…”

“…Immunohistochemistry using anti-platelet antibody (CD41) confirmed platelet-rich thrombus, not fibrin-rich thrombus (Fig 3A,B). These pathological and immunohistochemical findings ware compatible with HIT, [12][13][14][15] although none of these findings was specific to HIT. Multiple organ necrosis suggesting DIC was not observed.…”

Seizures, headache and thrombocytopenia: diagnosis and treatment do not always come in a standard sequence

“…In a cohort of 120 patients with HIT, recruited over a period of 11 years and studied retrospectively, 3 patients suffered from cerebral venous thrombosis [24]. Two other fatal cases were reported without details [25,26].…”