Hewitt R L, Akers D L, Leissinger C A, Gill J I, Aster R H
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
J Vasc Surg. 1998 Sep;28(3):561-5. doi: 10.1016/s0741-5214(98)70146-6.
We report the occurrence of acute heparin-induced thrombocytopenia in a patient with anaphylaxis that began immediately after an intravenous bolus dose of unfractionated heparin. This case report is the first to document the concurrence of these 2 reactions to heparin. An abrupt fall in platelet count was documented immediately after the anaphylactic response. Study results for antibodies characteristic of heparin-induced thrombocytopenia were positive in 2 assays: serotonin release assay and heparin platelet factor 4 enzyme-linked immunosorbent assay. The patient's antibody was exclusively immunoglobulin G. Any explanation for the relationship between the antibody response observed and the histamine release remains speculative.
