| Heparin-induced thrombocytopenia with thrombosis syndrome managed with plasmapheresis. | |
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MedLine Citation:
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PMID: 19129243 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Heparin-induced thrombocytopenia with thrombosis syndrome is an antibody-mediated disorder that has a high mortality in cardiac surgical patients in spite of early diagnosis and management with direct thrombin inhibitors. Plasmapheresis, an extracorporeal technique that has been designed for the removal of large molecular weight substances from the plasma, can remove the offending antibodies from these desperately ill patients. We describe a case of a postoperative cardiac surgery patient with heparin-induced thrombocytopenia with thrombosis syndrome and multi-system failure who was dependent upon a left ventricular assist device. He was treated successfully with plasmapheresis with recovery of his platelet count from 25,000/microl to over 200,000/microl, along with multi-organ recovery. This patient survived because of plasmapheresis. Removing the antibodies to the heparin-platelet factor four complex with plasmapheresis is an effective strategy to treat these patients. We believe that the use of plasmapheresis as a bail-out procedure in these often desperately ill post-operative cardiac surgical patients who have heparin-induced thrombocytopenia with thrombosis syndrome could be lifesaving. |
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Authors:
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Robert Kramer; Payson Oberg-Higgins; Louis Russo; John H Braxton |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-01-07 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 8 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-23 Completed Date: 2009-06-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 439-41 Citation Subset: IM |
Affiliation:
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Division of Cardiothoracic Surgery, Maine Medical Center, Portland, ME 04102, USA. kramer@mmc.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies
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blood Anticoagulants / adverse effects*, immunology Coronary Artery Bypass Heart-Assist Devices Heparin / adverse effects*, immunology Humans Male Middle Aged Multiple Organ Failure / chemically induced, therapy Plasmapheresis* Syndrome Thrombocytopenia / chemically induced, immunology, therapy* Thrombosis / chemically induced, immunology, therapy* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antibodies; 0/Anticoagulants; 9005-49-6/Heparin |
| Comments/Corrections | |
Comment In:
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Interact Cardiovasc Thorac Surg. 2009 Apr;8(4):441
[PMID:
19304774
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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