Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia
Previous exposition to heparin and protamine in patients undergoing cardiopulmonary bypass and postoperative therapeutic anticoagulation with LMWH may lead to the development of heparin-induced thrombocytopenia (HIT) and/or protamine-induced thrombocytopenia (PIT). This case deals with a rare clinic...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2020/4503598 |
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| _version_ | 1849408858632486912 |
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| author | Caroline Holaubek Paul Simon Sabine Eichinger-Hasenauer Franz Gremmel Barbara Steinlechner |
| author_facet | Caroline Holaubek Paul Simon Sabine Eichinger-Hasenauer Franz Gremmel Barbara Steinlechner |
| author_sort | Caroline Holaubek |
| collection | DOAJ |
| description | Previous exposition to heparin and protamine in patients undergoing cardiopulmonary bypass and postoperative therapeutic anticoagulation with LMWH may lead to the development of heparin-induced thrombocytopenia (HIT) and/or protamine-induced thrombocytopenia (PIT). This case deals with a rare clinical presentation of circulating IgG antibodies against heparin/platelet factor 4 complexes and heparin/protamine complexes after cardiac surgery. Ensuing purpura and skin necrosis (blisters) at the injection sites of LMWH and clinical symptoms improved rapidly after replacement of LMWH by an alternative anticoagulant. The aim of this report is to draw attention to the several different clinical manifestations of heparin- and/or protamine-induced thrombocytopenia and shows a possible course of treatment and recovery. |
| format | Article |
| id | doaj-art-7f4b55e7d13c47aa84b90d8c4bae6341 |
| institution | Kabale University |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-7f4b55e7d13c47aa84b90d8c4bae63412025-08-20T03:35:40ZengWileyCase Reports in Immunology2090-66092090-66172020-01-01202010.1155/2020/45035984503598Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced ThrombocytopeniaCaroline Holaubek0Paul Simon1Sabine Eichinger-Hasenauer2Franz Gremmel3Barbara Steinlechner4Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, Medical University of Vienna, Vienna, AustriaDivision of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDivision of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, AustriaDivision of Cardiac Surgery, Medical University of Vienna, Vienna, AustriaDivision of Cardiothoracic and Vascular Anesthesia and Intensive Care, Medical University of Vienna, Vienna, AustriaPrevious exposition to heparin and protamine in patients undergoing cardiopulmonary bypass and postoperative therapeutic anticoagulation with LMWH may lead to the development of heparin-induced thrombocytopenia (HIT) and/or protamine-induced thrombocytopenia (PIT). This case deals with a rare clinical presentation of circulating IgG antibodies against heparin/platelet factor 4 complexes and heparin/protamine complexes after cardiac surgery. Ensuing purpura and skin necrosis (blisters) at the injection sites of LMWH and clinical symptoms improved rapidly after replacement of LMWH by an alternative anticoagulant. The aim of this report is to draw attention to the several different clinical manifestations of heparin- and/or protamine-induced thrombocytopenia and shows a possible course of treatment and recovery.http://dx.doi.org/10.1155/2020/4503598 |
| spellingShingle | Caroline Holaubek Paul Simon Sabine Eichinger-Hasenauer Franz Gremmel Barbara Steinlechner Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia Case Reports in Immunology |
| title | Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia |
| title_full | Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia |
| title_fullStr | Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia |
| title_full_unstemmed | Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia |
| title_short | Injection Site Erythema in a Patient on Therapeutic Anticoagulation with Low Molecular Weight Heparin after Mechanical Aortic Valve Replacement: A Rare Presentation of Heparin- and Protamine-Induced Thrombocytopenia |
| title_sort | injection site erythema in a patient on therapeutic anticoagulation with low molecular weight heparin after mechanical aortic valve replacement a rare presentation of heparin and protamine induced thrombocytopenia |
| url | http://dx.doi.org/10.1155/2020/4503598 |
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