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Delayed‐onset heparin‐induced thrombocytopenia A potentially malignant syndrome
Author(s) -
Van Der Weyden Martin B.,
Hunt Hilary,
McGrath Kathy,
Fawcett Terry,
Fitzmaurice Anne,
Sawers Ron J.,
Rosengarten David S.
Publication year - 1983
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1983.tb122363.x
Subject(s) - medicine , heparin induced thrombocytopenia , heparin , thrombosis , pulmonary embolism , surgery , myocardial infarction , platelet factor 4 , venous thrombosis , superior sagittal sinus , complication , anesthesia
Delayed‐onset thrombocytopenia developed in 12 patients while they were receiving either prophylactic or therapeutic heparin. Five of the patients had thrombocytopenia alone, and seven had thromboembolic complications which contributed to the death of one patient. These complications included deep venous thrombosis (four patients), pulmonary embolism (three patients), myocardial infarction (one patient), sagittal sinus thrombosis (one patient), and femoral artery occlusion (one patient). The diagnosis of heparin‐induced thrombocytopenia was delayed for between one and 13 days after the initial complicating event. All patients had heparin‐dependent platelet‐ aggregating factor in their plasma. The characteristics of the heparin‐dependent platelet‐aggregating reaction were the same in all patients, but the nadir of thrombocytopenia was lower in patients with delayedonset heparin‐induced thrombocytopenia and complicating thromboembolism. These findings highlight the necessity for early recognition of this syndrome and for the prompt withdrawal of heparin to prevent considerable patient morbidity.