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Successful use of fondaparinux in the setting of heparin‐induced thrombocytopenia with thrombosis confirmed by serotonin‐release assay and Factor V Leiden
Author(s) -
Fraielli Kyle,
Patel Dimple,
Wang Diana,
Sargent Kathleen,
Gore Joel
Publication year - 2019
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12994
Subject(s) - fondaparinux , medicine , heparin induced thrombocytopenia , heparin , thrombosis , anesthesia , anticoagulant , warfarin , surgery , venous thromboembolism , atrial fibrillation
Abstract What is known and objective The off‐label use of fondaparinux in patients with heparin‐induced thrombocytopenia with thrombosis (HITT) has historically been controversial. We present a case of successful fondaparinux use to treat HITT confirmed by the serotonin‐release assay in the setting of other significant clotting and bleeding risk factors. Case summary We report a 19‐year‐old male with a history of Factor V Leiden and recent neurosurgery treated with fondaparinux after developing HITT confirmed by the serotonin‐release assay (SRA). The patient achieved full platelet recovery on fondaparinux and was successfully transitioned to warfarin therapy without further thrombotic nor bleeding complications. What is new and conclusion This case demonstrates a clear example of success of fondaparinux use to treat SRA‐confirmed HITT in the setting of complicating factors and adds to the existing literature supporting the use of fondaparinux for HIT.