Journal
AMERICAN JOURNAL OF HEMATOLOGY
Volume 80, Issue 4, Pages 288-291Publisher
WILEY
DOI: 10.1002/ajh.20436
Keywords
heparin-induced; thrombocytopenia; thrombotic thrombocytopenic purpura; post-operative; cardiac surgery; pulmonary embolism
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Up to 50% of patients undergoing coronary artery bypass surgery will develop antibodies against the heparin-platelet factor 4 complex, and a small percentage of those will go on to develop heparin-induced thrombocytopenia. Thrombotic thrombocytopenic purpura has also been reported post-coronary artery bypass surgery. In this case report, we describe a patient who developed both heparin-induced thrombocytopenia and thrombotic thrombocytopenic purpura post-coronary artery bypass surgery. This patient had clinical features consistent with both entities, and the clinical picture could not be explained by either heparin-induced thrombocytopenia or thrombotic thrombocytopenic purpura alone. It is hypothesized that these two entities may be related in this patient population, and this case report emphasizes the challenges in the diagnosis of thrombocytopenia in this patient population.
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