[Cerebrovascular complications of immunologically mediated heparin-induced thrombocytopenia]

Fortschr Neurol Psychiatr. 2014 Mar;82(3):149-54. doi: 10.1055/s-0034-1365923. Epub 2014 Mar 10.
[Article in German]

Abstract

Immunologically mediated heparin-induced thrombocytopenia (HIT) is a thrombotic disease caused by antibodies occurring after heparin exposure. Thrombocytopenia occurs within a few days after heparin exposure, about half of HIT-patients develop venous or arterial thrombotic complications. Neurological complications of HIT are mainly ischaemic stroke and sinus vein thrombosis. To ensure the primary clinical diagnosis functional and immunological assays for antibody detection are available. The probability for the occurrence of HIT depends on the nature of heparin employed (LMWH vs. UFH) and individual patient characteristics such as gender and primary disease (medical vs. surgical patients). In the case of suspected HIT heparin administration should be discontinued immediately and replaced by an alternative anticoagulation to prevent the expansion or development of further thrombotic complications. Herein we report a case of a patient suffering from HIT-associated embolic cerebral ischaemic stroke.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Aged
  • Antibodies / analysis
  • Antibodies / immunology
  • Anticoagulants / adverse effects*
  • Anticoagulants / chemistry
  • Brain Ischemia / etiology
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / etiology*
  • Echocardiography, Transesophageal
  • Heparin / adverse effects*
  • Heparin / chemistry
  • Heparin, Low-Molecular-Weight / adverse effects
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Intracranial Thrombosis / etiology
  • Intracranial Thrombosis / prevention & control
  • Male
  • Sinus Thrombosis, Intracranial / etiology
  • Stroke / etiology
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / complications*
  • Thrombocytopenia / immunology*

Substances

  • Antibodies
  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Heparin