Refractory Heparin-Induced Thrombocytopenia With Cerebral Venous Sinus Thrombosis Treated With IVIg, Steroids, and a Combination of Anticoagulants: A Case Report. (April 2019)

• Record Type: Journal Article
• Authors: Gonzales, Mia; Pipalia, Amrish; Weil, Andrew
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 7(2019)
• Publication Date: 2019-04
• Subjects: heparin-induced thrombocytopenia -- cerebral venous sinus thrombosis -- IVIg -- refractory HIT -- autoimmune HIT; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/2324709619832324
• Languages: English
• ISSNs: 2324-7096

Abstract

Heparin-induced thrombocytopenia (HIT) type II is caused by antibody production that bind complexes between heparin and platelet factor 4 leading to platelet consumption and thrombosis. In a small subset of cases referred to as autoimmune HIT, the antibodies activate platelets even in the absence of heparin. Refractory HIT is a type of autoimmune HIT in which thrombocytopenia persists for weeks after heparin discontinuation and carries increased risk for thrombosis and more severe thrombocytopenia. We present a case of refractory HIT with cerebral venous sinus thrombosis (CVST) that was successfully treated with a change in anticoagulant alongside steroids and a second trial of intravenous immunoglobulin (IVIg).