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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| Format: | Article |
| Language: | English |
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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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| author | Min Woo Hwang William B. Ershler |
| author_facet | Min Woo Hwang William B. Ershler |
| author_sort | Min Woo Hwang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3554c2c4702d4b88b4ebaf147fd506a7 |
| institution | OA Journals |
| issn | 2767-7664 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-3554c2c4702d4b88b4ebaf147fd506a72025-08-20T02:11:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-06-013610.7326/aimcc.2024.0095Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous ImmunoglobulinMin Woo Hwang0William B. Ershler11Internal Medicine Residency Program, Inova Fairfax Medical Campus, Falls Church, Virginia2Department of Hematology and Medical Oncology, Inova Fairfax Hospital, Fairfax, VirginiaA 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.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0095 |
| spellingShingle | Min Woo Hwang William B. Ershler Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin Annals of Internal Medicine: Clinical Cases |
| title | Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin |
| title_full | Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin |
| title_fullStr | Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin |
| title_full_unstemmed | Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin |
| title_short | Postviral Platelet-Activating Anti-PF4 Disorder Responsive to High-Dose Intravenous Immunoglobulin |
| title_sort | postviral platelet activating anti pf4 disorder responsive to high dose intravenous immunoglobulin |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0095 |
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