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肝素诱导的血小板减少症（HIT）伴5-羟色胺释放试验（SRA）阴性时的正在形成的肺栓塞（PE）

Pulmonary Embolism (PE) in Transit in Heparin-Induced Thrombocytopenia (HIT) With Negative Serotonin-Release Assay (SRA).

作者信息

Cheema Tayyab, Kieu Tri, Balek Mark, Ahmad Muhammad, Singh Pooja

机构信息

Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, USA.

Internal Medicine, West Suburban Medical Center, Oak Park, USA.

出版信息

Cureus. 2022 Jun 12;14(6):e25868. doi: 10.7759/cureus.25868. eCollection 2022 Jun.

DOI:10.7759/cureus.25868
PMID:35698467
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9188760/
Abstract

Pulmonary embolism (PE) is a potentially lethal condition, although frequently diagnosed, and is rarely associated with transit on initial presentation. Heparin-induced thrombocytopenia (HIT) can cause both arterial thrombus formation and venous thromboembolism. The two forms of HIT must be differentiated in order to guide management. We present a complex and unique case of PE in transit secondary to HIT diagnosed in a patient with a negative serotonin assay.

摘要

肺栓塞（PE）是一种潜在的致命疾病，尽管其诊断较为常见，但在初次就诊时很少与血栓移行相关。肝素诱导的血小板减少症（HIT）可导致动脉血栓形成和静脉血栓栓塞。必须区分这两种形式的HIT以指导治疗。我们报告了一例复杂且独特的病例，该患者血清素检测呈阴性，诊断为继发于HIT的移行性肺栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/45e475ba64c3/cureus-0014-00000025868-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/9bda1ece7f29/cureus-0014-00000025868-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/91a9321e85d6/cureus-0014-00000025868-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/dbd93a085754/cureus-0014-00000025868-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/45e475ba64c3/cureus-0014-00000025868-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/9bda1ece7f29/cureus-0014-00000025868-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/91a9321e85d6/cureus-0014-00000025868-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/dbd93a085754/cureus-0014-00000025868-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e98d/9188760/45e475ba64c3/cureus-0014-00000025868-i04.jpg

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本文引用的文献

1
Right Ventricular Thrombus in Transit: Raising the Stakes in the Management of Pulmonary Embolism.移动性右心室血栓：提高肺栓塞治疗的风险
CASE (Phila). 2019 Jul 2;3(6):272-276. doi: 10.1016/j.case.2019.05.006. eCollection 2019 Dec.
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Serotonin-release assay-negative heparin-induced thrombocytopenia.血清素释放试验阴性肝素诱导的血小板减少症。
Am J Hematol. 2020 Jan;95(1):38-47. doi: 10.1002/ajh.25660. Epub 2019 Nov 6.
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J Am Coll Cardiol. 2003 Jun 18;41(12):2245-51. doi: 10.1016/s0735-1097(03)00479-0.
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Treatment of right heart thromboemboli.右心血栓栓塞的治疗。
Chest. 2002 Mar;121(3):806-14. doi: 10.1378/chest.121.3.806.