%0 Journal Article
%T Catastrophic Complications of Intravenous Line Flushing with Unfractionated Heparin
%A Giuseppe Colucci
%A Maximilian Jahns
%A Tobias Silzle
%A Lorenzo Alberio
%J International Journal of Clinical Medicine
%P 36-39
%@ 2158-2882
%D 2012
%I Scientific Research Publishing
%R 10.4236/ijcm.2012.31007
%X Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome because diagnosis is based on both clinical symptoms and laboratory data. We report a patient with multiple thromboembolic complications after daily flushing of intravenous line with small amounts of unfractionated heparin (UFH). At day 7 bilateral hemorrhagic infarction of the adrenal glands was misdiagnosed as adrenal adenoma. On day 10 thrombocytopenia was noted and the next day a myocardial infarction complicated by a left ventricular thrombus was diagnosed. On day 12, HIT was suspected. The pre-test probability for HIT according to the 4T-score was high (8/8 points) and detection of antibodies directed against the PF4/heparin-complex by particle gel immunoassay (Titer 1:1024) and ELISA (O.D. 2.784) was strongly positive. HIT can be induced by iv-line flushes with UFH. Arterial and venous thrombotic complications can be present before a clear platelet drop can be recognised.
%K Heparin-Induced Thrombocytopenia
%K Adrenal Haemorrhagic Necrosis
%K 4T Score
%K PF4/Heparin-Antibodies
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=16820