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Treatment of refractory delayed onset heparin‐induced thrombocytopenia after thoracic endovascular aortic repair with intravenous immunoglobulin (IVIG)

2017; Elsevier BV; Volume: 1; Issue: 1 Linguagem: Inglês

10.1002/rth2.12009

2475-0379

Kimberley Doucette, Christin B. DeStefano, Natasha A. Jain, Allan Louie Cruz, Vera Malkovska, Kelly Fitzpatrick,

Intramuscular injections and effects

Delayed onset heparin induced thrombocytopenia (HIT), is characterized by a late nadir due to persistent platelet-activating IgG antibodies. It typically begins or worsens 5 or more days after heparin is discontinued with complications such as thrombosis up to 3 weeks after exposure to heparin.1-3 In 50% of cases, the platelet count can decrease to very low numbers (<20 000/μL), which is not usual for typical HIT. Here we report 2 cases of post-operative delayed onset HIT manifesting as severe thrombocytopenia that persisted despite cessation of heparin and initiation of argatroban. Key Clinical Question: Is intravenous immunoglulin beneficial in severe refractory delayed-onset HIT?