Correction of Severe Heparin-Associated Thrombocytopenia with Intravenous Immunoglobulin
Authors: James N. Frame
Journal: Annals of Internal Medicine (1989)

Brief Reports1 December 1989Correction of Severe Heparin-Associated Thrombocytopenia with Intravenous ImmunoglobulinJames N. Frame, MD, Kevin P. Mulvey, MD, John C. Phares, MD, Michael J. Anderson, MDJames N. Frame, MD, Kevin P. Mulvey, MD, John C. Phares, MD, Michael J. Anderson, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-11-946 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHeparin-associated thrombocytopenia develops in approximately 5% of patients treated with heparin (1) and generally occurs after 2 to 10 days of therapy (2). While platelets usually increase to over 100 X 109/L within 2 to 19 days after heparin discontinuation (3), this disorder rarely causes clinical bleeding or warrants platelet transfusion. We report the first case of severe heparin-associated thrombocytopenia complicated by intestinal bleeding and progressive thrombocytopenia that had intestinal bleeding stopped and normal platelet counts restored shortly after the administration of intravenous immunoglobulin.Case ReportA 62-year-old woman was referred to us with a 5-day history of deep venous...References1. KingKelton DJ. Heparin-associated thrombocytopenia. Ann Intern Med. 1984;100:535-40. LinkGoogle Scholar2. BellTomasuloAlvingDuffy WPBT. Thrombocytopenia occurring during the administration of heparin: a prospective study in 52 patients. Ann Intern Med. 1976;85:155-60. LinkGoogle Scholar3. Bell W. Heparin-associated thrombocytopenia and thrombosis. J Lab Clin Med. 1988;111:600-5. MedlineGoogle Scholar4. BaumannMenitoveAsterAnderson MJRT. Urgent treatment of idiopathic thrombocytopenic purpura with single-dose gammaglobulin infusion followed by platelet transfusion. Ann Intern Med. 1986;104:808-9. LinkGoogle Scholar5. CinesKaywinBinaTomaskiSchreiber DPMAA. Heparin-associated thrombocytopenia. N Engl J Med. 1980;303:788-95. CrossrefMedlineGoogle Scholar6. SilverKapschTsoi DDE. Heparin-induced thrombocytopenia, thrombosis, and hemorrhage. Ann Surg. 1983;198:301-6. CrossrefMedlineGoogle Scholar7. VogelsangKicklerBell GTW. Post-transfusion purpura: a report of five patients and a review of pathogenesis and management. Am J Hematol. 1986;21:259-67. CrossrefMedlineGoogle Scholar8. BusselSchulmanHilgartnerBarandun JIMS. Intravenous use of gammaglobulin in the treatment of chronic idiopathic thrombocytopenic purpura as a means to defer splenectomy. J Pediatr. 1983;103:651-4. CrossrefMedlineGoogle Scholar9. SheridanCarterKelton DCJ. A diagnostic test for heparin-induced thrombocytopenia. Blood. 1986;67:27-30. CrossrefMedlineGoogle Scholar10. KeltonSheridanSantos JDA. Heparin-induced thrombocytopenia: laboratory studies. Blood. 1988;72:925-30. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the National Naval Medical Center and the Uniformed Services University of the Health Sciences, Bethesda, Maryland. For current author addresses, see end of text. 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