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DOI: 10.1055/s-0029-1220702
© Georg Thieme Verlag KG Stuttgart · New York
Lepirudin Treatment in a Girl with Iliac Vein Thrombosis, Severe Pulmonary Embolism and Suspected Heparin-induced Thrombocytopenia (HIT) II
Behandlung mit Lepirudin bei einem Mädchen mit tiefer Beinvenenthrombose, schwerer Lungenembolie und Verdacht auf Heparin-induzierte Thrombozytopenie (HIT) Typ IIPublication History
Publication Date:
12 May 2009 (online)
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Abstract
We report on a 15-year-old girl referred to us for dyspnea. Investigations revealed multiple pulmonary emboli originating from iliac vein thrombosis. As under heparin therapy, d-dimers rose again and the thrombus grew significantly in size while platelet count decreased by >30%. A diagnosis of heparin-induced thrombocytopenia (HIT) type II was suspected, heparin-treatment was stopped and lepirudin therapy was started successfully at a dosis of 0.15 mg/kg bw/hr.
Zusammenfassung
Wir berichten von einem 15-jährigen Mädchen, das wegen Luftnot vorgestellt wurde; ursächlich waren multiple Lungenembolien aufgrund einer tiefen Beinvenenthrombose. Da der Thrombus trotz Heparintherapie an Größe zunahm, wurde der Verdacht auf eine heparininduzierte Thrombozytopenie (HIT) Typ II gestellt.
Key words
heparin-induced thrombocytopenia - HIT type II - Lepirudin - thromboembolism - Hirudin
Schlüsselwörter
heparininduzierte Thrombozytopenie - HIT Typ II - Lepirudin - Thromboembolie - Hirudin
References
- 1 Deitcher SR, Ngengwe R, Kaplan R. et al . Subcutaneous lepirudin for heparin-induced thrombocytopenia and when other anticoagulants fail: illustrative cases. Clin Adv Hematol Oncol. 2004; 2 382-384 , ; discussion 384–386
- 2 Girolami B, Girolami A. Heparin-induced thrombocytopenia: a review. Semin Thromb Hemost. 2006; 32 803-809
- 3 Gobel U, Witt O. Pitfalls of clinical registries in pediatric oncology and hematology. Klin Padiatr. 2008; 220 129-133
- 4 Lubenow N, Greinacher A. Drugs for the prevention and treatment of thrombosis in patients with heparin-induced thrombocytopenia. Am J Cardiovasc Drugs. 2001; 1 429-443
- 5 Monagle P, Chan A, Massicotte P. et al . Antithrombotic therapy in children: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126 645S-687S
- 6 Risch L, Fischer JE, Herklotz R. et al . Heparin-induced thrombocytopenia in paediatrics: clinical characteristics, therapy and outcomes. Intensive Care Med. 2004; 30 1615-1624
- 7 Warkentin TE. Think of HIT. Hematology Am Soc Hematol Educ Program. 2006; 408-414
Correspondence
Dr. Kerstein Nanette Walter
Zentrum für Kinder- und Jugendmedizin – Klinik I
Mathildenstr. 1
79106 Freiburg
Germany
Phone: +49/761/270 4301
Fax: +49/761/270 4481
Email: kerstin.walter@uniklinik-freiburg.de