自发性肝素诱导的血小板减少伴发双侧脑血管梗死和急性冠状动脉综合征

IF 0.9 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Jong Kun Park, I. Vavilin, Jacob Zaemes, Araba Ofosu-Somuah, Raghav Gattani, C. Sahebi, A. Truesdell
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引用次数: 0

摘要

背景:自发性肝素诱导的血小板减少症是一种在没有肝素暴露的情况下产生抗肝素抗体的促血栓综合征。病例介绍:一名78岁的男子在出院5天后因中风样症状成功接受了腰椎椎板切除术,并被发现患有双侧额叶急性梗死。患者被发现患有严重的血小板减少症,偶然发现有下壁心肌梗死。进一步的调查导致诊断为双侧下肢深静脉血栓形成。他的总体临床表现促使进行了详细的血液学检查,表明尽管之前没有接触过肝素产品,但肝素诱导的血小板减少症呈阳性。结论:该病例说明了一名既往无肝素暴露的患者,他接受了椎板切除术,随后发展为双侧额叶急性梗死、下壁心肌梗死和双侧下肢深静脉血栓,并担心自发性肝素诱导的血小板减少症的后遗症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spontaneous Heparin-Induced Thrombocytopenia Presenting as Concomitant Bilateral Cerebrovascular Infarction and Acute Coronary Syndrome
Background: Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure. Case presentation: A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes. The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction. Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses. His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocytopenia despite no previous exposure to heparin products. Conclusions: This case illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes, an inferior wall myocardial infarction, and bilateral lower extremity deep vein thromboses, with concern for sequelae of spontaneous heparin-induced thrombocytopenia.
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来源期刊
Cardiovascular Innovations and Applications
Cardiovascular Innovations and Applications CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.80
自引率
20.00%
发文量
222
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