A Case Report of Type Ⅱ HIT Induced by the Anticoagulation Therapy

LI Guang-hai; GAO Wen-ting; SONG Zhi-ying; ZHANG Wang-de

doi:10.3969/j.issn.1002-3429.2017.01.025

Abstract：Objective To investigate key points in diagnosis and treatment of heparin-induced thrombocytopenia (HIT)induced by the anticoagulation therapy(DVT)of lower limbs. Methods Clinical data of one acute DVT of lower limbs patient with type Ⅱ HIT induced by anticoagulation therapy of low molecular heparin was retrospectively analyzed,and relevant literature was also reviewed. Results The patient was admitted for acute DVT. Doppler ultrasound showed that thrombosis was from left lower superficial femoral vein to the popliteal vein. The patient was subcutaneously injected with 5000 U low molecular heparin by one time for every 12 h and other supportive treatments. Platelet count rapidly reduced to 8 × 109/L after treatment for 1 week,and general thrombosis of both veins of lower extremities was found by rechecking doppler ultrasound,and 4Ts score was 7. Type Ⅱ HIT was confirmed after excluding other etiological factors of thrombocyto-penia. Platelet count returned to normal levels gradually,and thrombosis was controlled after replacing the low molecular hep-arin and containing heparinic tube sealing fluid to Argatroban. Anticoagulation therapy with Warfarin continued for 3 months at least after discharge for preventing recurrence. Conclusion Type Ⅱ HIT is a very dangerous,and 4Ts scores combined with heparin dependent platelet antibody test can help the diagnosis. If HIT happens,heparin drugs should be discontinued imme-diately,and the therapeutic dose of anticoagulant drugs should be given at the same time. Those are the key points in treat-ment of type Ⅱ HIT.