Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin
A 54-year-old man presented with diffuse bleeding and thrombosis and was initially considered to have immune thrombocytopenia and, later, disseminated intravascular coagulation. Ultimately, the condition was determined to be due to a platelet-activating antiplatelet factor 4 (anti-PF4) disorder, pre...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
American College of Physicians
2024-06-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0095 |
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| Summary: | A 54-year-old man presented with diffuse bleeding and thrombosis and was initially considered to have immune thrombocytopenia and, later, disseminated intravascular coagulation. Ultimately, the condition was determined to be due to a platelet-activating antiplatelet factor 4 (anti-PF4) disorder, preceded by an upper respiratory infection in the absence of prior heparin use. The heparin antibody assay showed a highly positive titer at 2.301 OD, with a strongly positive serotonin release assay at 78% with 0.1 U/mL unfractionated heparin, confirming the diagnosis. We successfully managed the postviral anti-PF4 disorder with intravenous immunoglobulin, in addition to anticoagulation with argatroban. |
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| ISSN: | 2767-7664 |