Persistent heparin-induced thrombocytopenia: Danaparoid cross-reactivity or delayed-onset heparin-induced thrombocytopenia? A case report

Research output: Contribution to journalArticle

Abstract

Clinical suspicion of immune heparin-induced thrombocytopenia (HIT) requires cessation of heparin and initiation of an alternative anticoagulant. The platelet count will subsequently recover. This case report describes the clinical course of a patient after a cardiovascular surgery. HIT was clinically and biologically confirmed. Unexpectedly, the platelet count did not recover despite the arrest of heparin. Danaparoid was initiated, and thrombocytopenia persisted. Danaparoid cross-reactivity was suspected, and laboratory assay was performed. Results were misinterpreted because no comparative buffer control was performed to ensure that the platelet aggregation was caused by danaparoid. Moreover, plasma/serum must be diluted to demonstrate this effect. Danaparoid cross-reactivity was incorrectly concluded, and the patient was switched to bivalirudin. The severe thrombocytopenia persisted. Plasmapheresis was started, and platelet count finally increased. The clinical course suggested a delayed-onset HIT. This case report illustrates the need for appropriate testing to differentiate drug cross-reactivity from delayed-onset HIT.

Original languageEnglish
Pages (from-to)193-197
Number of pages5
JournalBlood Coagulation and Fibrinolysis
Volume28
Issue number2
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • Bivalirudin
  • danaparoid
  • plasmapheresis
  • thrombocytopenia

Fingerprint Dive into the research topics of 'Persistent heparin-induced thrombocytopenia: Danaparoid cross-reactivity or delayed-onset heparin-induced thrombocytopenia? A case report'. Together they form a unique fingerprint.

  • Student Theses

    Analytical and clinical validation of sensitive assays for the diagnosis of immune heparin-induced thrombocytopenia

    Author: Minet, V., 2017

    Supervisor: Dogne, J. (Supervisor), Mullier, F. (External person) (Co-Supervisor), Laloy, J. (Jury), Lucas, S. (Jury), Masereel, B. (Jury), Chatelain, M. (External person) (Jury), Hoylaerts, M. F. (External person) (Jury) & Tardy, B. (External person) (Jury)

    Student thesis: Doc typesDoctor of Biomedical and Pharmaceutical Sciences

    Cite this