Background: High-dose intravenous immunoglobulin (IVIg) can be effective for patients with refractory autoimmune heparin-induced thrombocytopenia (HIT). We report two patients with autoimmune HIT (aHIT) successfully treated with early high-dose IVIg.
Case description: Case 1 was a 48-year-old male who had persisting HIT with recurrent ischemic stroke after mitral valve replacement. Case 2 was a 71-year-old male who had flush heparin HIT with cerebral venous thrombosis after total hip arthroplasty. High-dose IVIg was administered 6 and 4 days after starting argatroban due to non-improved thrombocytopenia and persistently high D-dimer values, respectively. Both patients achieved favorable functional recovery at discharge as well as improvements of thrombocytopenia and hypercoagulation.
Conclusions: Early high-dose IVIg may be effective for patients with aHIT and hypercoagulability.
Keywords: Autoimmune HIT; Flush heparin HIT; Heparin-induced thrombocytopenia (HIT); Intravenous immunoglobulin (IVIg); Persisting HIT; Stroke.
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