Rapid-onset heparin-induced thrombocytopenia without previous heparin exposure

Zsolt Olah, Adrienne Kerenyi, J. Kappelmayer, Agota Schlammadinger, Katalin Razso, Z. Boda

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Heparin-induced thrombocytopenia (HIT) is one of the most common immune-mediated drug reactions. Immunoglobulin G-type antibodies against platelet factor 4(PF4)/heparin complexes are known to play a key role in the pathogenesis of HIT. Rapid-onset HIT is caused by the presence of circulating HIT antibodies at the time of heparin readministration. These antibodies are generally resulted from a recent immunizing exposure to heparin. Here we report a case of rapid-onset HIT developed after a septicemia without previous heparin exposure. The diagnosis of HIT as well as the presence of platelet activating and heparin-dependent antibodies was confirmed by ELISA and flow cytometric functional assays. Our case report reinforces that rapid-onset HIT cannot be excluded only based on the absence of previous heparin exposure. In addition, it may support the new theory of pre-immunization by PF4-coated bacteria in the pathomechanism of HIT. We also call the attention that venous limb gangrene can be rarely associated with HIT and thrombosis even in the absence of coumarin therapy. Furthermore, transient presence of anti-phospholipid antibodies can cause a differential diagnostic problem in the cases of HIT.

Original languageEnglish
Pages (from-to)495-498
Number of pages4
JournalPlatelets
Volume23
Issue number6
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Thrombocytopenia
Heparin
Platelet Factor 4
Antibodies
Gangrene
Anti-Idiotypic Antibodies
Immunization
Phospholipids
Sepsis
Thrombosis
Blood Platelets
Extremities
Immunoglobulin G

Keywords

  • Antiphospholipid antibodies
  • Heparin
  • Limb gangrene
  • Platelet factor 4
  • Sepsis
  • Thrombocytopenia

ASJC Scopus subject areas

  • Hematology

Cite this

Rapid-onset heparin-induced thrombocytopenia without previous heparin exposure. / Olah, Zsolt; Kerenyi, Adrienne; Kappelmayer, J.; Schlammadinger, Agota; Razso, Katalin; Boda, Z.

In: Platelets, Vol. 23, No. 6, 09.2012, p. 495-498.

Research output: Contribution to journalArticle

Olah, Zsolt ; Kerenyi, Adrienne ; Kappelmayer, J. ; Schlammadinger, Agota ; Razso, Katalin ; Boda, Z. / Rapid-onset heparin-induced thrombocytopenia without previous heparin exposure. In: Platelets. 2012 ; Vol. 23, No. 6. pp. 495-498.
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