Karki Sailesh, Aryal Binit, Mainali Arjun, Uprety Navodita, Panigrahi Kalpana, Adhikari Samaj
Internal Medicine, Interfaith Medical Center, Brooklyn, USA.
Internal Medicine, One Brooklyn Health, Interfaith Medical Center, Brooklyn, USA.
Cureus. 2023 Jul 13;15(7):e41812. doi: 10.7759/cureus.41812. eCollection 2023 Jul.
Heparin-induced thrombocytopenia (HIT) is categorized into type 1 and type 2. It causes a decrease in platelet count during or shortly after exposure to heparin. Type 1 is mild and has a non-immune mechanism. Type 2 is a hypercoagulable state resulting from anti-heparin platelet factor 4 (PF4) IgG antibodies. These antibodies cause the activation of endothelium and thrombin generation. Type 2 HIT is complicated by life-threatening thromboembolic events such as deep venous thrombosis, pulmonary embolism, and myocardial infarction. HIT remains an under-recognized cause of dialysis catheter dysfunction and thrombosis. We present a case of a 66-year-old male with recurrent dialysis catheter thrombosis secondary to Type 2 HIT. Avoiding heparin-based dialysis or switching to non-heparin-based anticoagulation or peritoneal dialysis are the possible management strategies for such patients.
肝素诱导的血小板减少症（HIT）分为1型和2型。它会在接触肝素期间或之后不久导致血小板计数下降。1型较轻，具有非免疫机制。2型是由抗肝素血小板因子4（PF4）IgG抗体引起的高凝状态。这些抗体会导致内皮激活和凝血酶生成。2型HIT会并发危及生命的血栓栓塞事件，如深静脉血栓形成、肺栓塞和心肌梗死。HIT仍然是透析导管功能障碍和血栓形成的一个未被充分认识的原因。我们报告一例66岁男性因2型HIT继发反复透析导管血栓形成的病例。对于此类患者，避免使用肝素进行透析或改用非肝素抗凝或腹膜透析是可能的管理策略。
