Treating heparin-induced thrombocytopenia. The unconventional way!
Abdel-Razeq, H.N.; Bajouda, A.A.; Khalil, M.M.; Ashmeg, A.K.
Saudi Medical Journal 25(9): 1258-1260
2004
ISSN/ISBN: 0379-5284 PMID: 15448779 Document Number: 583418
Heparin-induced thrombocytopenia (HIT) is a potentially devastating complication of heparin therapy. The severe form of HIT has been associated with both venous and arterial thrombosis manifested by myocardial infarction, cerebrovascular occlusion, skin necrosis or limb ischemia. Several agents are now available as alternatives to heparin in patients with suspected HIT, including the thrombin specific inhibitors lepirudin and argatroban as well as the low molecular weight heparinoid known as danaparoid. When lacking these agents, here we report the use of plasmapheresis to create an artificial state of anticoagulation; exchanging patient's plasma with albumin rather than fresh frozen plasma, to allow the safe introduction of warfarin.