Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis - case report and systematic review of dabigatran use

Vasa. 2021 Feb;50(2):151-156. doi: 10.1024/0301-1526/a000876. Epub 2020 Jun 29.

Abstract

A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

Keywords: acute limb ischemia; bleeding; dabigatran etexilate; heparin-induced thrombocytopenia; myelofibrosis; venous thromboembolism.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Anticoagulants / adverse effects
  • Dabigatran / adverse effects
  • Heparin / adverse effects
  • Humans
  • Ischemia / diagnosis
  • Ischemia / diagnostic imaging
  • Male
  • Middle Aged
  • Primary Myelofibrosis* / complications
  • Primary Myelofibrosis* / diagnosis
  • Primary Myelofibrosis* / drug therapy
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / drug therapy
  • Thrombosis*

Substances

  • Anticoagulants
  • Heparin
  • Dabigatran