Department of Cardiology, Selcuk University, Meram School of Medicine, Konya, Turkey.
Clin Appl Thromb Hemost. 2011 Oct;17(5):546-8. doi: 10.1177/1076029610379399. Epub 2010 Aug 10.
A 69-year-old woman presented to the emergency department with sudden onset of dyspnea. She reported bilateral total knee surgery 12 days prior for gonarthrosis. The patient was recommended low-molecular-weight heparin (LMWH) 0.4 cc (4 milliliter) twice a day. On evaluation, severe thrombocytopenia was detected. An echocardiogram was performed because of her dyspnea, which revealed right ventricular dilatation and hypokinesis. Due to suspicion of a pulmonary embolism (PE), a pulmonary computed tomography (CT) was performed, which revealed bilateral massive PE. This event occurred while the patient was receiving LMWH for prophylaxis of PE. Due to the presence of severe thrombocytopenia, fondaparinux and immunoglobulin were initiated. Her platelet levels improved significantly and she was discharged on warfarin.
一位 69 岁女性因突发呼吸困难到急诊科就诊。她报告说，12 天前因膝关节骨关节炎接受了双侧全膝关节手术。患者被建议每日两次使用低分子肝素（LMWH）0.4 毫升（4 毫升）。在评估时，发现严重血小板减少症。由于呼吸困难进行了超声心动图检查，结果显示右心室扩张和运动功能减退。由于怀疑肺栓塞（PE），进行了肺部计算机断层扫描（CT），结果显示双侧大量 PE。这一事件发生在患者接受 LMWH 预防 PE 期间。由于严重血小板减少症的存在，开始使用磺达肝素和免疫球蛋白。她的血小板水平显著改善，并出院改用华法林。
