Key result
A 78-year-old man developed heparin-induced thrombocytopenia complicated by deep vein thrombosis and pulmonary thromboembolism after esophagectomy, which was successfully managed with argatroban and an IVC filter.
Case Report (n=1)
No
Highlights the importance of early diagnosis and alternative anticoagulation in heparin-induced thrombocytopenia to prevent fatal thromboembolic complications.
症例は脳梗塞の既往を有し抗血小板薬を内服中の78歳の男性で，食道癌に対し手術を行った．術前は抗血小板薬をヘパリンに置換．術後ヘパリン再開後に血小板値が3.5×104/μLに急激に減少し，ヘパリン起因性血小板減少症（Heparin Induced Thrombocytopenia;HIT）を疑った．ヘパリンをアルガトロバンへ変更し，血小板値は徐々に改善した．その後，深部静脈血栓症・肺動脈血栓症を発症し，下大静脈フィルターを留置した．深部静脈血栓の消失を確認後，アルガトロバンをエドキサバントシルへ変更し，下大静脈フィルターを抜去した．HITはまれな疾患ではあるが，適切な治療を行わなければ血栓塞栓症を合併し，致死的な病態に至ることもあり，早期診断，治療が必要である．ヘパリン使用時には，本疾患の認識が必要である．
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Nishida et al. (2019) conducted a case report in Esophageal cancer, Heparin-induced thrombocytopenia (HIT) (n=1). Heparin was evaluated on Development of heparin-induced thrombocytopenia and thromboembolic complications. A 78-year-old man developed heparin-induced thrombocytopenia complicated by deep vein thrombosis and pulmonary thromboembolism after esophagectomy, which was successfully managed with argatroban and an IVC filter.
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