PMID- 35449622
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230413
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 3
DP  - 2022 Mar
TI  - Early Utilization of Intravenous Immunoglobulin in Heparin-Induced 
      Thrombocytopenia for Limb Salvaging Purposes.
PG  - e23202
LID - 10.7759/cureus.23202 [doi]
LID - e23202
AB  - We present a case of a 28-year-old diabetic female who presented with high-burden 
      lower extremity deep vein thrombosis (DVT) after previous exposure to 
      unfractionated heparin (UFH). Heparin was discontinued, and non-heparin 
      parenteral anticoagulant, argatroban, was started based on a high clinical 
      suspicion of heparin-induced thrombocytopenia with thrombosis (HITT). The 
      diagnosis of HIT was later proven by positive immune and functional assays. The 
      severity of thrombocytopenia and the need for surgical intervention to salvage 
      the limb prompted the use of intravenous immunoglobulin (IVIG) early on in the 
      treatment course to recover platelet counts, halt the prothrombotic state, and 
      prepare the patient for thrombectomy. The patient was put on direct oral 
      anticoagulants (DOACs), apixaban, after thrombectomy, and platelet count recovery 
      with no new thrombosis or bleeding episodes was reported after three months of 
      follow-up.
CI  - Copyright (c) 2022, Abu Kar et al.
FAU - Abu Kar, Sarah
AU  - Abu Kar S
AD  - Internal Medicine, Richmond University Medical Center, Staten Island, USA.
FAU - Kaur, Amandeep
AU  - Kaur A
AD  - Hematology and Oncology, Richmond University Medical Center, Staten Island, USA.
FAU - Khan, Ahmed M
AU  - Khan AM
AD  - Radiology, Richmond University Medical Center, Staten Island, USA.
FAU - Bloomfield, Dennis
AU  - Bloomfield D
AD  - Research, Richmond University Medical Center, Staten Island, USA.
LA  - eng
PT  - Case Reports
DEP - 20220315
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9012574
OTO - NOTNLM
OT  - argatroban
OT  - autoimmune hit
OT  - hypercoagulable state
OT  - ivig
OT  - platelet factor 4
OT  - rapid-onset hit
OT  - serotonin release assay
OT  - venous thromboembolism
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/04/23 06:00
MHDA- 2022/04/23 06:01
PMCR- 2022/03/15
CRDT- 2022/04/22 06:28
PHST- 2022/03/15 00:00 [accepted]
PHST- 2022/04/22 06:28 [entrez]
PHST- 2022/04/23 06:00 [pubmed]
PHST- 2022/04/23 06:01 [medline]
PHST- 2022/03/15 00:00 [pmc-release]
AID - 10.7759/cureus.23202 [doi]
PST - epublish
SO  - Cureus. 2022 Mar 15;14(3):e23202. doi: 10.7759/cureus.23202. eCollection 2022 
      Mar.