Successful Use of Intravenous Immunoglobulin G to Treat Refractory Heparin-Induced Thrombocytopenia With Thrombosis Complicating Peripheral Blood Stem Cell Harvest
نویسندگان
چکیده
Heparin-induced thrombocytopenia is a well-known, life-threatening complication that occurs in 5% of patients exposed to heparin. It causes thrombocytopenia in roughly 85% to 90% of affected individuals, with expected recovery in approximately 4 to 10 days following heparin withdrawal. However, there is an entity known as refractory heparin-induced thrombocytopenia with thrombosis in which patients have prolonged thrombocytopenia, refractory to the current standard of care. We present one such case of a 48-year-old male with R-ISS (Revised International Staging System) stage II kappa light chain multiple myeloma in stringent complete response status postinduction therapy. He developed heparin-induced thrombocytopenia with thrombosis during peripheral blood stem cell harvesting, manifesting as acute right coronary artery thrombus and severe thrombocytopenia. Although his clinical course was prolonged, he was ultimately successfully treated with intravenous immunoglobulin G 500 mg/kg/day over 4 days.
منابع مشابه
Central venous catheters and upper-extremity deep-vein thrombosis complicating immune heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia (HIT) is a transient antibody-mediated hypercoagulability state strongly associated with lower-limb deep-vein thrombosis (DVT). Whether HIT is additionally associated with upper-limb DVT--either with or without central venous catheter (CVC) use--is unknown. We therefore studied 260 patients with antibody-positive HIT to determine the influence of CVC use on freq...
متن کاملبروز ترومبوسیتوپنی ناشی ازهپارین، در دو روش تجویز داخل وریدی در بیماران با سندرم حاد کرونری
Incidence of Thrombocytopenia Induced by Two Methods of Intravenous Heparin injection in Patients with Acute Coronary Syndrome. H. Nough MD1* , A. Khodadadi Zadeh MSc2, M. Aref 3, A. Esmaieli Nadimi MD1 1- Assisstant Professor of Cardiology, University of Medical Sciences, Rafsanjan, Iran 2- Academic Member, Dept. of Nursing, Faculty of Nursing Midwifery, University of Medical Sci...
متن کاملSuccessful treatment of refractory immune hemolysis following unrelated cord blood transplant with Campath-1H.
Immune-mediated hemolytic anemia is a well-recognized complication of hematopoietic stem cell transplantation. We report on a 6-year-old boy with X-linked adrenoleukodystrophy who developed severe delayed alloimmune hemolytic anemia associated with immune-mediated neutropenia and thrombocytopenia following major ABO incompatible unrelated cord blood transplantation. The patient's cytopenias wer...
متن کاملAntibodies from patients with heparin-induced thrombocytopenia stimulate monocytic cells to express tissue factor and secrete interleukin-8.
Thrombosis is a life-threatening complication that occurs in a subset of patients with heparin-induced thrombocytopenia (HITT). The pathogenic mechanisms underlying the variable occurrence of thrombosis in HITT is poorly understood. It was hypothesized that monocyte activation leading to tissue factor expression may play a role in promoting a thrombogenic state in HITT. This study demonstrates ...
متن کامل