Two patients with heparin‐induced thrombocytopenia followed by idiopathic (immune) thrombocytopenic purpura: Case Report

Waheed, Faisal; Naseer, Noman; Ahmed, Tauseef; Nelson, John

doi:10.1002/ajh.10368

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Interestingly, all were younger than 40 years of age, and half of them were seropositive for HIV [123,124]. Two patients with HIT followed by ITP have been reported by Waheed [125]. Recently, Espinoza et al [126] described 46 patients with thrombotic microangiopathic hemolytic anemia (TMHA) associated with aPLA.…”

Section: Association Of Diseasesmentioning

confidence: 99%

Thrombocytopenic conditions—autoimmunity and hypercoagulability: Commonalities and differences in ITP, TTP, HIT, and APS

Kravitz

Shoenfeld

2005

American J Hematol

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Immune thrombocytopenia purpura (ITP), thrombotic thrombocytopenia purpura (TTP), heparin‐induced thrombocytopenia (HIT), and antiphospholipid syndrome (APS) are clinical conditions associated with significant morbidity and mortality. These well‐defined clinical syndromes have in common several properties: (1) their pathogenesis is immune mediated, specifically by autoantibodies; (2) thrombocytopenia is a hallmark in these four conditions; (3) except for the case of ITP, platelet and endothelial cell activation occurs in TTP, HIT, and APS, resulting in a prothrombotic state and an increased risk of thrombosis. Although these four immune‐mediated syndromes are well‐defined diseases, several case reports and studies have documented the association of two diseases in the same patient, illustrating the concept of the kaleidoscope of autoimmunity. Am. J. Hematol. 80:232–242, 2005. © 2005 Wiley‐Liss, Inc.

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Section: Association Of Diseasesmentioning

confidence: 99%

Thrombocytopenic conditions—autoimmunity and hypercoagulability: Commonalities and differences in ITP, TTP, HIT, and APS

Kravitz

Shoenfeld

2005

American J Hematol

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“…However, the promptness of increase following cortisone treatment, considering the long half-life of fondaparinux [10] strongly indicates that immune thrombocytopenia was part of the cause. Two cases of HIT followed by immune thrombocytopenia have been previously reported [11]; however, the precise pathophysiological mechanisms are unclear.…”

Section: Discussionmentioning

confidence: 99%

Management of a Patient With Subdural Hematoma Complicated by the Presence of Heparin-Induced and Suspected Concomitant Immune Thrombocytopenia: A Case Report

2015

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A patient with antiphospholipid syndrome treated with warfarin presented to the emergency department with a traumatic subdural hematoma. Two days following the evacuation of the hematoma, treatment with low molecular weight heparin (LMWH) was initiated. One week later, the patient developed new symptoms. The hematoma had relapsed and the platelet count had decreased considerably. The thrombocytopenia was diagnosed as heparin-induced and the anticoagulant treatment was discontinued. Following increase of the platelet count, treatment with fondaparinux was initiated. However, 1 day following that, the platelet count had decreased again and cross-reaction between the LMWH and fondaparinux was suspected. Due to the risk of hematoma relapse, the patient started treatment with cortisone, responding promptly. The platelet count was stabilized and the patient resumed the treatment with warfarin without complications. The thrombocytopenia was initially heparin-induced and complicated by the cross-reaction between LMWH and fondaparinux as well as the presence of suspected autoimmune thrombocytopenia, as suggested by the response to corticosteroids. This case report illustrates the difficulties in diagnosing and managing thrombocytopenia of complex etiology.

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“…Both cannot be fully confirmed using objective laboratory tests. Therefore, this is not the first published case where those types of thrombocytopenia are considered simultaneously or in sequence [ 7 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…To summarise, the example of our patient may illustrate the “kaleidoscope of immunity” phenomenon [ 13 ], where two or more autoimmune diseases co-exist in one patient – one after another or as overlap syndromes. However, according to data this problem is rather casuistic if concerning thrombocytopenic conditions [ 7 , 8 ]. On the other hand, the course of hospitalization of our patient and the difficulties in management were also due to still imperfect diagnostic methods and limitations in their availability, as well as in cooperation with other specialists, including a haematologist, even in clinical hospitals.…”

Section: Discussionmentioning

confidence: 99%

Severe thrombocytopenia soon after drug-eluting stent implantation in ST-elevation myocardial infarction

Łebek-Szatańska¹,

Pośnik-Kisło²,

Błaszak-Ciećwierska³

et al. 2015

pwki

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Thrombocytopenia is among the most frequent haematological issues in patients hospitalised with myocardial infarction. We discuss the case of a 77-year-old male who was admitted to hospital on the 4th hour of ST-elevation myocardial infarction of the anterior wall. A percutaneous coronary intervention to critically stenoted initial segment of the anterior descending branch was performed. A few days later he started developing symptomatic thrombocytopenia. On the course of his long hospitalization we faced many important problems, concerning both diagnosis and treatment of these co-existing conditions.

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Two patients with heparin‐induced thrombocytopenia followed by idiopathic (immune) thrombocytopenic purpura: Case Report

Cited by 4 publications

References 18 publications

Thrombocytopenic conditions—autoimmunity and hypercoagulability: Commonalities and differences in ITP, TTP, HIT, and APS

Thrombocytopenic conditions—autoimmunity and hypercoagulability: Commonalities and differences in ITP, TTP, HIT, and APS

Management of a Patient With Subdural Hematoma Complicated by the Presence of Heparin-Induced and Suspected Concomitant Immune Thrombocytopenia: A Case Report

Severe thrombocytopenia soon after drug-eluting stent implantation in ST-elevation myocardial infarction

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