PMID- 35573471
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2049-0801 (Print)
IS  - 2049-0801 (Electronic)
IS  - 2049-0801 (Linking)
VI  - 78
DP  - 2022 Jun
TI  - Accelerated heparin-induced thrombocytopenia in a COVID-19 patient; a case report 
      with literature review.
PG  - 103749
LID - 10.1016/j.amsu.2022.103749 [doi]
LID - 103749
AB  - INTRODUCTION: Heparin-induced thrombocytopenia (HIT) is a rare and serious 
      immune-mediated complication of heparin therapy which is seldom reported in 
      association with COVID-19. This report aims to present a case of accelerated HIT 
      in a severe COVID-19 patient. CASE REPORT: A 63-year-old man presents with 
      symptoms of COVID-19 for one week. He was conscious, ordinated, feverish, and had 
      diffused chest crackles. Initial laboratory tests revealed elevated C-reactive 
      protein of 87.66 mg/dL, elevated D-dimmer of 1258.9 ng/ml, elevated ferritin of 
      1020 ng/ml, and his platelet count was within the normal range. Polymerase chain 
      reaction (PCR) confirmed the diagnosis of COVID-19. On the 9th day of admission, 
      he developed a progressive worsening of dyspnea. His D-dimmer level significantly 
      increased to 7020 ng/ml, and his interleukin-6 was 27.3 pg/ml. Hence, we started 
      him on unfractionated heparin (UFH) for thromboprophylaxis. On the 12th day of 
      hospitalization, the platelet count dropped from 258000 to 111000 cells/muL. He 
      had a high probability of HIT (4Ts score = 6). As a result, we discontinued UFH 
      and switched him to apixaban. His platelet count normalized (174000 cells/muL) 
      within two weeks of ceasing UHF. DISCUSSION: HIT results from the production of 
      antibodies against platelet factor 4/heparin complexes. It is associated with a 
      diminished platelet count within 5-10 days post heparin initiation. Because 
      thrombocytopenia can occur in COVID-19 patients, HIT is seldom suspected. 
      CONCLUSION: HIT should be considered a differential diagnosis in COVID-19 
      patients with thrombocytopenia.
CI  - (c) 2022 The Authors.
FAU - Mohammed, Hemin S
AU  - Mohammed HS
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
FAU - Fattah, Fattah H
AU  - Fattah FH
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
AD  - College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, 
      Kurdistan, Iraq.
FAU - Rahim, Hawbash M
AU  - Rahim HM
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
AD  - Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
AD  - Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey.
FAU - Kakamad, Fahmi H
AU  - Kakamad FH
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
AD  - College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, 
      Kurdistan, Iraq.
AD  - Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
FAU - Mohammed, Shvan H
AU  - Mohammed SH
AD  - Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
FAU - Salih, Rawezh Q
AU  - Salih RQ
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
AD  - Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq.
FAU - Salih, Abdulwahid M
AU  - Salih AM
AD  - Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
AD  - College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, 
      Kurdistan, Iraq.
FAU - Naqar, Sharo
AU  - Naqar S
AD  - College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, 
      Kurdistan, Iraq.
LA  - eng
PT  - Case Reports
DEP - 20220511
PL  - England
TA  - Ann Med Surg (Lond)
JT  - Annals of medicine and surgery (2012)
JID - 101616869
PMC - PMC9090824
OTO - NOTNLM
OT  - COVID-19
OT  - Heparin-induced thrombocytopenia
OT  - Platelet
OT  - Unfractionated heparin
COIS- None to be declared.
EDAT- 2022/05/17 06:00
MHDA- 2022/05/17 06:01
PMCR- 2022/05/11
CRDT- 2022/05/16 04:28
PHST- 2022/03/10 00:00 [received]
PHST- 2022/05/07 00:00 [revised]
PHST- 2022/05/08 00:00 [accepted]
PHST- 2022/05/17 06:00 [pubmed]
PHST- 2022/05/17 06:01 [medline]
PHST- 2022/05/16 04:28 [entrez]
PHST- 2022/05/11 00:00 [pmc-release]
AID - S2049-0801(22)00509-X [pii]
AID - 103749 [pii]
AID - 10.1016/j.amsu.2022.103749 [doi]
PST - ppublish
SO  - Ann Med Surg (Lond). 2022 Jun;78:103749. doi: 10.1016/j.amsu.2022.103749. Epub 
      2022 May 11.