Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty
A 72-year-old Caucasian woman was admitted for an elective left total knee arthroplasty. Her surgery was uncomplicated and she was discharged to a rehabilitation facility. Twelve days later, she developed acute shortness of breath followed by a syncopal episode. She was hypoxic and cyanotic, requiri...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/4918623 |
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| author | Kevin Baker Ming Y. Lim |
| author_facet | Kevin Baker Ming Y. Lim |
| author_sort | Kevin Baker |
| collection | DOAJ |
| description | A 72-year-old Caucasian woman was admitted for an elective left total knee arthroplasty. Her surgery was uncomplicated and she was discharged to a rehabilitation facility. Twelve days later, she developed acute shortness of breath followed by a syncopal episode. She was hypoxic and cyanotic, requiring hospitalization and intubation, and was subsequently diagnosed with bilateral submassive pulmonary emboli and bilateral lower extremity deep vein thrombosis. She was started on unfractionated heparin infusion. Within 24 hours of exposure, she had an acute decrease in platelet count to 48,000. Heparin was discontinued and argatroban was initiated due to concern for heparin-induced thrombocytopenia (HIT). Both quantitative enzyme immunoassay and functional assay confirmed the diagnosis of HIT. The patient had no prior lifetime heparin exposure. Given the absence of preceding heparin therapy, this case is consistent with the diagnosis of spontaneous HIT. |
| format | Article |
| id | doaj-art-4be95edbd5ef4091b2c7f037523b002b |
| institution | DOAJ |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-4be95edbd5ef4091b2c7f037523b002b2025-08-20T03:20:13ZengWileyCase Reports in Hematology2090-65602090-65792017-01-01201710.1155/2017/49186234918623Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee ArthroplastyKevin Baker0Ming Y. Lim1Department of Medicine, Medical University of South Carolina, Charleston, SC, USADepartment of Medicine, Division of Hematology/Oncology, Medical University of South Carolina, Charleston, SC, USAA 72-year-old Caucasian woman was admitted for an elective left total knee arthroplasty. Her surgery was uncomplicated and she was discharged to a rehabilitation facility. Twelve days later, she developed acute shortness of breath followed by a syncopal episode. She was hypoxic and cyanotic, requiring hospitalization and intubation, and was subsequently diagnosed with bilateral submassive pulmonary emboli and bilateral lower extremity deep vein thrombosis. She was started on unfractionated heparin infusion. Within 24 hours of exposure, she had an acute decrease in platelet count to 48,000. Heparin was discontinued and argatroban was initiated due to concern for heparin-induced thrombocytopenia (HIT). Both quantitative enzyme immunoassay and functional assay confirmed the diagnosis of HIT. The patient had no prior lifetime heparin exposure. Given the absence of preceding heparin therapy, this case is consistent with the diagnosis of spontaneous HIT.http://dx.doi.org/10.1155/2017/4918623 |
| spellingShingle | Kevin Baker Ming Y. Lim Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty Case Reports in Hematology |
| title | Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty |
| title_full | Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty |
| title_fullStr | Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty |
| title_full_unstemmed | Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty |
| title_short | Spontaneous Heparin-Induced Thrombocytopenia and Venous Thromboembolism following Total Knee Arthroplasty |
| title_sort | spontaneous heparin induced thrombocytopenia and venous thromboembolism following total knee arthroplasty |
| url | http://dx.doi.org/10.1155/2017/4918623 |
| work_keys_str_mv | AT kevinbaker spontaneousheparininducedthrombocytopeniaandvenousthromboembolismfollowingtotalkneearthroplasty AT mingylim spontaneousheparininducedthrombocytopeniaandvenousthromboembolismfollowingtotalkneearthroplasty |