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Chronic fondaparinux use in a hemodialysis patient with heparin‐induced thrombocytopenia type II and extracorporeal circuit thrombosis—A case report and review of the literature
Author(s) -
Brown Paula,
Jay Richard,
Fox Andrea,
Oliver Matthew
Publication year - 2013
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12003
Subject(s) - fondaparinux , medicine , hemodialysis , heparin , heparin induced thrombocytopenia , thrombosis , extracorporeal , dialysis , low molecular weight heparin , anticoagulant , surgery , anesthesia , intensive care medicine , venous thromboembolism
Heparin‐induced thrombocytopenia ( HIT ) is a potentially life‐threatening condition that can develop after exposure to unfractionated or low–molecular‐weight heparins. Treatment options appear to be limited in patients on concurrent intermittent hemodialysis. We report the case of an 88‐year‐old man newly initiated on high‐flux hemodialysis who developed HIT and extracorporeal circuit thrombosis after 3 weeks of exposure to unfractionated heparin. Our patient was successfully treated with fondaparinux 2.5 mg subcutaneously three times per week and citrate during dialysis sessions. Antifactor X a levels were measured on several occasions while receiving fondaparinux.