A pulmonary embolism caused by delayed-onset heparin-induced thrombocytopenia in a patient with ischemic stroke

Intern Med. 2009;48(11):921-4. doi: 10.2169/internalmedicine.48.1925. Epub 2009 Jun 1.

Abstract

We report a case of an acute stroke patient with pulmonary embolism (PE) caused by delayed-onset heparin-induced thrombocytopenia (HIT). She was treated with heparin to prevent neurological deterioration. However, 5 days after heparin had been given for 7 days, she developed PE. Heparin was re-started, but the platelet count decreased significantly, and a right ventricular thrombus appeared. She was finally diagnosed as having PE due to delayed-onset HIT because the HIT antibody was positive. When a patient develops thrombotic events during or after heparin therapy, the possibility of HIT should be considered.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brain Ischemia / complications
  • Brain Ischemia / diagnosis*
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Female
  • Heparin / administration & dosage
  • Heparin / adverse effects*
  • Humans
  • Pulmonary Embolism / chemically induced
  • Pulmonary Embolism / diagnosis*
  • Stroke / complications
  • Stroke / diagnosis*
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / diagnosis*

Substances

  • Delayed-Action Preparations
  • Heparin