Heparin-induced thrombocytopenia as a cause of prolonged low platelet count in a patient with thrombotic thrombocytopenic purpura treated with plasmapheresis

• Authors: Agata Winiarska , Norbert Kwella , Tomasz Stompór
• Languages of publication: EN

Abstracts

EN

Thrombotic thrombocytopenic purpura (TTP) is a rare disorder belonging to thrombotic microangiopathies (TMA) and is caused by functional deficiency of the ADAMTS-13 metalloproteinase. Plasma exchange (PE) remains the treatment of choice in this disease. Here, were describe the case of a patient who apparently recovered from TTP following multiple sessions of PE, but remained thrombocytopenic. Careful analysis revealed the development of heparin-induced thrombocytopenia (HIT) that precluded platelet count (PLT) normalization. Full normalization of PLT followed discontinuation of PE and low-molecular weight heparin.

Keywords

EN

heparin-induced thrombocytopenia; plasma exchange; thrombotic thrombocytopenic purpura

• Publisher: Polish Biochemical Society
• Journal: Acta Biochimica Polonica
• Year: 2017
• Volume: 64
• Issue: 2
• Pages: 375-376

Dates

published

2017

received

2016-09-17

revised

2016-10-20

accepted

2016-10-20

(unknown)

2017-04-05

Contributors

author

Agata Winiarska

• Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland

author

Norbert Kwella

• Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland

author

Tomasz Stompór

• Department of Nephrology, Hypertension and Internal Medicine, Chair of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland

References

• Tersteeg C, Verhenne S, Roose E, Schelpe AS, Deckmyn H, De Meyer SF, Vanhoorelbeke K. (2016) ADAMTS13 and anti-ADAMTS13 autoantibodies in thrombotic thrombocytopenic purpura - current perspectives and new treatment strategies. Expert Rev Hematol 9: 209–221. doi: 10.1586/17474086.2016.1122515.
• Warkentin TE (2015) Heparin-induced thrombocytopenia. Curr Opin Crit Care 21: 576-585. doi: 10.1097/MOH.0000000000000273.
• Studt JD, Binet I, Nair G, Schanz U (2013) Heparin-induced thrombocytopenia associated with thrombotic microangiopathy. Hamostaseologie 33: 160-163. doi: 10.5482/HAMO-13-03-0012.
• Benke S, Moltzan C (2005) Co-existence of heparin-induced thrombocytopenia and thrombotic thrombocytopenic purpura in a postoperative cardiac surgery patient. Am J Hematol 80: 288-291.
• Takatsuka H, Nakajima T, Nomura K, Wakae T, Toda A, Itoi H, Okada M, Misawa M, Hara H (2005) Heparin-induced thrombocytopenia antibody and the pathogenesis of thrombotic microangiopathy after stem cell transplantation. Clin Transplant 19: 418-422.

Identifiers

DOI

10.18388/abp.2016_1428