A rare case of heparin-induced thrombocytopenia following long-term chronic hemodialysis
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- Kagitani Satoshi
- Second Department of Internal Medicine, University of Toyama
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- Tomoda Fumihiro
- Second Department of Internal Medicine, University of Toyama
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- Sugawara Hidenori
- Yokota Hospital
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- Koike Tsutomu
- Second Department of Internal Medicine, University of Toyama
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- Imai Yuko
- Second Department of Internal Medicine, University of Toyama
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- Fujioka Hayato
- Second Department of Internal Medicine, University of Toyama
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- Mizutani Minami
- Second Department of Internal Medicine, University of Toyama
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- Shida Shinobu
- Second Department of Internal Medicine, University of Toyama
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- Kakeshita Kota
- Second Department of Internal Medicine, University of Toyama
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- Taki Tomohiko
- Second Department of Internal Medicine, University of Toyama
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- Miyamoto Mayumi
- Second Department of Internal Medicine, University of Toyama
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- Motoyoshi Kanako
- Second Department of Internal Medicine, University of Toyama
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- Oh-hara Maiko
- Second Department of Internal Medicine, University of Toyama
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- Ichikawa Kumi
- Second Department of Internal Medicine, University of Toyama
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- Hirose Masayo
- Second Department of Internal Medicine, University of Toyama
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- Yamazaki Hidenori
- Second Department of Internal Medicine, University of Toyama
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- Nakagawa Taizo
- Second Department of Internal Medicine, University of Toyama
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- Takabayashi Daisuke
- Second Department of Internal Medicine, University of Toyama
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- Sugimori Hiroko
- Second Department of Internal Medicine, University of Toyama
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- Inoue Hiroshi
- Second Department of Internal Medicine, University of Toyama
Bibliographic Information
- Other Title
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- 長期維持透析患者に発症したヘパリン起因性血小板減少症 (HIT) の稀有な1例
- 症例報告 長期維持透析患者に発症したヘパリン起因性血小板減少症(HIT)の稀有な1例
- ショウレイ ホウコク チョウキ イジ トウセキ カンジャ 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(HIT)ノ ケウ ナ 1レイ
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Abstract
A 58-year-old man had been treated with hemodialysis using heparin as an anticoagulant since December 1991. Eosinophilia appeared in November 2005 without changes in other clinical and laboratory findings. In August 2006 (15 years after the start of dialysis), blood coagulation in the dialyzer and extracorporeal circuit began to occur during hemodialysis. Blood coagulation gradually worsened, despite an increase in the dose of heparin and change of the dialysis membrane, which was then accompanied by chest discomfort and severe hypotension just after the commencement of dialysis. Both blood coagulation and shock during hemodialysis were improved by the administration of aspirin. However, aspirin administration ceased because of skin itching, after which the above symptoms recurred. Laboratory data disclosed an extreme decrease in platelet count after hemodialysis and specific immunoglobulin G antibodies to platelet factor 4-heparin complex. Accordingly, the patient was diagnosed with heparin-induced thrombocytopenia (HIT) and heparin was changed to nafamostat mesilate as an anticoagulant. Clotting in dialysis equipment, thrombocytopenia, shock during hemodialysis, and eosinophilia were all improved following the use of nafamostat mesilate. The present case was a rare case of HIT characterized by late occurrence following long-term hemodialysis for 15 years, complication of shock during dialysis, and eosinophilia preceding the onset of HIT.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 46 (12), 1169-1173, 2013
The Japanese Society for Dialysis Therapy
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Details 詳細情報について
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- CRID
- 1390001204679857536
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- NII Article ID
- 130003385741
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 025111333
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed