PMID- 32396515
OWN - NLM
STAT- MEDLINE
DCOM- 20200601
LR  - 20200601
IS  - 0001-5415 (Print)
IS  - 0001-5415 (Linking)
VI  - 87
IP  - 2
DP  - 2020
TI  - [Heparin-Induced Thrombocytopenia after Total Knee Replacement].
PG  - 129-133
AB  - Heparin-induced thrombocytopenia is a rare complication of treatment with both 
      unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Antibodies 
      against the complex heparin-platelet factor 4 are the main cause of pathogenesis, 
      resulting in the activation of thrombocytes, coagulation, endothelium, monocytes, 
      neutrophils and subsequent highly prothrombotic state. The prothrombotic state 
      can result not only in venous but also in arterial thrombosis at different 
      locations (which is manifested apart from venous thromboembolic disease also by 
      acute limb ischemia, acute myocardial infarction, ischemic stroke, skin 
      necrotizing lesion exanthema). If HIT is not adequately treated, it may be fatal 
      in up to 10% of patients. For early diagnosis, a combination of 4T scores and 
      diagnostic lab tests for HIT is required. Immediate discontinuation of heparin 
      therapy (UFH, LMWH) and switching to non-heparin anticoagulants (fondaparinux, 
      bivalirudin, argatroban or in some situations DOACs) are essential in HIT 
      treatment. The case report describes the patient after primary knee replacement, 
      complicated by the development of HIT with no evidence of venous thromboembolic 
      disease. Preoperatively, the patient was administrated nadroparin due to 
      paroxysmal atrial fibrillation, after the development of HIT, anticoagulation was 
      modified to fondaparinux and subsequently to warfarin after the platelet count 
      normalization. Key words: unfractioned heparin, low molecular weight heparin, 
      thrombocytopenia, total knee replacement.
FAU - Salasek, M
AU  - Salasek M
AD  - Klinika ortopedie a traumatologie pohyboveho ustroji Lekarske fakulty Univerzity 
      Karlovy a Fakultni nemocnice Plzen.
FAU - Slechtova, J
AU  - Slechtova J
FAU - Pavelk, T
AU  - Pavelk T
LA  - cze
PT  - Case Reports
PT  - Journal Article
TT  - Heparinem indukovana trombocytopenie po totalni endoproteze kolenniho kloubu.
PL  - Czech Republic
TA  - Acta Chir Orthop Traumatol Cech
JT  - Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
JID - 0407123
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*adverse effects
MH  - *Arthroplasty, Replacement, Knee
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Thrombocytopenia/*chemically induced/diagnosis/therapy
EDAT- 2020/05/13 06:00
MHDA- 2020/06/02 06:00
CRDT- 2020/05/13 06:00
PHST- 2020/05/13 06:00 [entrez]
PHST- 2020/05/13 06:00 [pubmed]
PHST- 2020/06/02 06:00 [medline]
PST - ppublish
SO  - Acta Chir Orthop Traumatol Cech. 2020;87(2):129-133.