Journal
HEMATOLOGY REPORTS
Volume 13, Issue 1, Pages -Publisher
MDPI
DOI: 10.4081/hr.2021.8857
Keywords
Heparin-induced thrombocytopenia; COVID-19; deep vein thrombosis; heparin; SARS-CoV-2; thrombocytopenia
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HIT can develop in COVID-19 patients treated with heparin, indicating a need to consider it as a possible cause of thrombocytopenia in such patients.
Heparin-induced thrombocytopenia (HIT) has not been included as a possible cause of thrombocytopenia in Coronavirus Disease 2019 (COVID-19) patients. We report a case of HIT in a patient with COVID-19 treated with heparin. A 78-year-old man was admitted to our hospital for acute respiratory failure and acute renal failure due to SARS-CoV-2 infection; in intensive care unit, one 5000IU heparin dose (day 0, platelet count 305000/mu L). On day 2, haemoglobin started to decrease and heparin was stopped. On day 10, platelet count was 153000/mu L and 5000IU calcium heparin subcutaneously twice daily was started. The platelet further decreased, reaching 49000/mu L on day 17, and the patient was investigated for suspected HIT: an IgG specific chemiluminescence test for heparin-PF4 antibodies was positive and a femoral DVT was found at ultrasound. Argatroban was started, platelet count increased without any bleeding and thrombosis complication. Our experience shows that HIT may develop in heparin treated COVID-19 patients and should be included among the possible cause of thrombocytopenia in such patients.
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