Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome
Само за регистроване кориснике
2008
Аутори
Perunicić, JovanAntonijević, Nebojša
Miljić, Predrag
Đorđević, Valentina
Miković, Danijela
Kovač, Mirjana
Đokić, Milan
Mrdović, Igor
Nikolić, Aleksandra
Vasiljević, Zorana
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Treatment of patients with heparin-induced thrombocytopenia type II (HIT II) and thrombosis in some cases that represents a clinical challenge, which, if unrecognized, may lead to treatment delay or disease progression with potentially lethal outcome. We present a case of a 19-year-old patient with antiphospholipid syndrome, factor V (FV) Leiden mutation in heterozygous state, and venous thromboembolism. The patient was subjected to intravenous infusions of unfractionated heparin (UFH), and 16 days after the beginning of the treatment, his condition worsened, with thrombocytopenia and extension of thrombosis. Whereas the patient had a high clinical score for HIT II, functional and antigenic assays for the presence of HIT antibodies were negative. After repeated negative functional and antigenic assays, pseudo-HIT was suspected and nadroparin was introduced, which resulted in further worsening of the clinical presentation. Disease remission, along with complete normalization of platelet... count, was finally accomplished with the introduction of lepirudin. The presence of multiple comorbid states, such as antiphospholipid syndrome, can potentially make laboratory confirmation of disease more difficult in patients with HIT II. In our opinion, it is of great importance that HIT II diagnosis be primarily clinical and that laboratory test results are carefully interpreted, especially when HIT is indicated by high clinical score values.
Кључне речи:
Pseudo-HIT / HIT IIИзвор:
Journal of Thrombosis and Thrombolysis, 2008, 26, 2, 142-146Издавач:
- Springer, Dordrecht
Финансирање / пројекти:
- Структурални елементи генома у модулацији фенотипа (RS-MESTD-MPN2006-2010-143051)
DOI: 10.1007/s11239-007-0076-y
ISSN: 0929-5305
PubMed: 17828468
WoS: 000260618500012
Scopus: 2-s2.0-56049099769
Институција/група
Institut za molekularnu genetiku i genetičko inženjerstvoTY - JOUR AU - Perunicić, Jovan AU - Antonijević, Nebojša AU - Miljić, Predrag AU - Đorđević, Valentina AU - Miković, Danijela AU - Kovač, Mirjana AU - Đokić, Milan AU - Mrdović, Igor AU - Nikolić, Aleksandra AU - Vasiljević, Zorana PY - 2008 UR - https://imagine.imgge.bg.ac.rs/handle/123456789/320 AB - Treatment of patients with heparin-induced thrombocytopenia type II (HIT II) and thrombosis in some cases that represents a clinical challenge, which, if unrecognized, may lead to treatment delay or disease progression with potentially lethal outcome. We present a case of a 19-year-old patient with antiphospholipid syndrome, factor V (FV) Leiden mutation in heterozygous state, and venous thromboembolism. The patient was subjected to intravenous infusions of unfractionated heparin (UFH), and 16 days after the beginning of the treatment, his condition worsened, with thrombocytopenia and extension of thrombosis. Whereas the patient had a high clinical score for HIT II, functional and antigenic assays for the presence of HIT antibodies were negative. After repeated negative functional and antigenic assays, pseudo-HIT was suspected and nadroparin was introduced, which resulted in further worsening of the clinical presentation. Disease remission, along with complete normalization of platelet count, was finally accomplished with the introduction of lepirudin. The presence of multiple comorbid states, such as antiphospholipid syndrome, can potentially make laboratory confirmation of disease more difficult in patients with HIT II. In our opinion, it is of great importance that HIT II diagnosis be primarily clinical and that laboratory test results are carefully interpreted, especially when HIT is indicated by high clinical score values. PB - Springer, Dordrecht T2 - Journal of Thrombosis and Thrombolysis T1 - Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome EP - 146 IS - 2 SP - 142 VL - 26 DO - 10.1007/s11239-007-0076-y ER -
@article{ author = "Perunicić, Jovan and Antonijević, Nebojša and Miljić, Predrag and Đorđević, Valentina and Miković, Danijela and Kovač, Mirjana and Đokić, Milan and Mrdović, Igor and Nikolić, Aleksandra and Vasiljević, Zorana", year = "2008", abstract = "Treatment of patients with heparin-induced thrombocytopenia type II (HIT II) and thrombosis in some cases that represents a clinical challenge, which, if unrecognized, may lead to treatment delay or disease progression with potentially lethal outcome. We present a case of a 19-year-old patient with antiphospholipid syndrome, factor V (FV) Leiden mutation in heterozygous state, and venous thromboembolism. The patient was subjected to intravenous infusions of unfractionated heparin (UFH), and 16 days after the beginning of the treatment, his condition worsened, with thrombocytopenia and extension of thrombosis. Whereas the patient had a high clinical score for HIT II, functional and antigenic assays for the presence of HIT antibodies were negative. After repeated negative functional and antigenic assays, pseudo-HIT was suspected and nadroparin was introduced, which resulted in further worsening of the clinical presentation. Disease remission, along with complete normalization of platelet count, was finally accomplished with the introduction of lepirudin. The presence of multiple comorbid states, such as antiphospholipid syndrome, can potentially make laboratory confirmation of disease more difficult in patients with HIT II. In our opinion, it is of great importance that HIT II diagnosis be primarily clinical and that laboratory test results are carefully interpreted, especially when HIT is indicated by high clinical score values.", publisher = "Springer, Dordrecht", journal = "Journal of Thrombosis and Thrombolysis", title = "Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome", pages = "146-142", number = "2", volume = "26", doi = "10.1007/s11239-007-0076-y" }
Perunicić, J., Antonijević, N., Miljić, P., Đorđević, V., Miković, D., Kovač, M., Đokić, M., Mrdović, I., Nikolić, A.,& Vasiljević, Z.. (2008). Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome. in Journal of Thrombosis and Thrombolysis Springer, Dordrecht., 26(2), 142-146. https://doi.org/10.1007/s11239-007-0076-y
Perunicić J, Antonijević N, Miljić P, Đorđević V, Miković D, Kovač M, Đokić M, Mrdović I, Nikolić A, Vasiljević Z. Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome. in Journal of Thrombosis and Thrombolysis. 2008;26(2):142-146. doi:10.1007/s11239-007-0076-y .
Perunicić, Jovan, Antonijević, Nebojša, Miljić, Predrag, Đorđević, Valentina, Miković, Danijela, Kovač, Mirjana, Đokić, Milan, Mrdović, Igor, Nikolić, Aleksandra, Vasiljević, Zorana, "Clinical challenge: heparin-induced thrombocytopenia type II (HIT II) or pseudo-HIT in a patient with antiphospholipid syndrome" in Journal of Thrombosis and Thrombolysis, 26, no. 2 (2008):142-146, https://doi.org/10.1007/s11239-007-0076-y . .