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A case of heparin-induced thrombocytopenia developed with anaphylaxis in a chronic hemodialysis patient
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- Isono Motohide
- Department of Medicine, Hemodialysis Center, Otsu Municipal Hospital
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- Mikami Daisuke
- Department of Dermatology, Otsu Municipal Hospital
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- Araki Hisazumi
- Department of Medicine, Hemodialysis Center, Otsu Municipal Hospital
Bibliographic Information
- Other Title
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- アナフィラキシーを契機に発症したヘパリン起因性血小板減少症の1例
- 症例報告 アナフィラキシーを契機に発症したヘパリン起因性血小板減少症の1例
- ショウレイ ホウコク アナフィラキシー オ ケイキ ニ ハッショウシタ ヘパリン キインセイ ケッショウバン ゲンショウショウ ノ 1レイ
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Description
We report a case of heparin-induced thrombocytopenia (HIT) complicated by anaphylaxis in a patient undergoing chronic hemodialysis. A 58-year-old man with polycystic kidney disease had received maintenance hemodialysis since 2001 using heparin without any complications. On Jan. 11, 2006, he had sweating, dyspnea and abdominal pain immediately after initiating hemodialysis. Since his arterial pressure and pO2 was decreased, hemodialysis was discontinued. Hematology test showed decreased platelet count from 36.8×104/mm3 to 11.4×104/mm3. There was blood coagulation in both arterial and venous chambers of circuit. Similar episode occurred when low-molecular heparin but not nafamostat mesilate was used as an anticoagulant during hemodialysis. HIT was highly suspected from these clinical manifestations. However, Anti-PF4/heparin antibodies were not detected and heparin-induced platelet activation assay was negative. Regarding the heparin allergy, the open patch test with heparin was positive. We diagnosed with HIT complicated with anaphylaxis induced by heparin on the basis of clinical symptoms. This is a rare case of HIT since it suddenly develops with anaphylaxis after long term use of heparin without the detection of HIT antibodies.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 40 (12), 1071-1075, 2007
The Japanese Society for Dialysis Therapy
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Details 詳細情報について
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- CRID
- 1390001204677703552
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- NII Article ID
- 10021274271
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 9318614
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL Search
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed