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Heparin as a cause of thrombus progression

Heparin-associated thrombocytopenia is an important differential diagnosis in paediatric patients even with normal platelet counts

  • Cardiology
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Abstract

A 15-year-old boy developed deep vein thrombosis of the right leg 9 days after appendectomy. In spite of three courses of thrombolysis with streptokinase and effective heparinization the thrombosis progressed with additional occlusion of the left iliac vein. Although platelet counts were constantly normal, heparin-associated thrombocytopenia was suspected as the cause of the new venous occlusions. This diagnosis was confirmed by detecting heparin-associated antibodies with the heparin-induced platelet activation test.

Therapy was instituted replacing heparin by the low molecular weight heparinoid Orgaran. Bilateral recanalization occurred within 6 days.

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Abbreviations

HAT :

heparin associated thrombocytopenia

HIPA test :

heparin-induced platelet activation test

LMW :

low molecular weight

r-tPA :

recombinant tissue plasminogen activator

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Authors and Affiliations

  1. Abteilung für Pädiatrie, Heinrich-Heine-Universität Düsseldorf, Postfach 101007, D-40001, Düsseldorf, Germany

    D. Klement & R. v. Kries

  2. Medizinische Einrichtungen der Universität Düsseldorf, Zentrum für Kinderheilkunde, Moorenstrasse 5, D-40225, Düsseldorf, Germany

    D. Klement

  3. Onassis Cardiac Center, Sygrou 356, GR-17674 Kalithea, Athens, Greece

    S. Rammos

  4. St. Bernhard-Hospital Kamp-Lintfort, Postfach 1820, D-47463, Kamp-Lintfort, Germany

    W. Krischke

  5. Abteilung für Gefäss-Chirurgie, Heinrich-Heine-Universität Düsseldorf, D-40001, Düsseldorf, Germany

    H. -W. Kniemeyer

  6. Institut für Immunologie und Transfusions-Medizin, Ernst-Montz-Arndt-Universität, Klinikum, Sauberbruchstrasse, D-17487, Greifswald, Germany

    A. Greinacher

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  1. D. Klement
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  2. S. Rammos
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  3. R. v. Kries
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  4. W. Krischke
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  5. H. -W. Kniemeyer
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  6. A. Greinacher
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Klement, D., Rammos, S., v. Kries, R. et al. Heparin as a cause of thrombus progression. Eur J Pediatr 155, 11–14 (1996). https://doi.org/10.1007/BF02115618

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  • DOI: https://doi.org/10.1007/BF02115618

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