Abstract
We report an 81-year-old Japanese man with heparin-induced thrombocytopenia (HIT). He had received thermal burns over 24% of his body surface (SDB-DB), afflicting his face and arms. He was urgently hospitalized in the ICU and managed by central venous catheters and an arterial monitoring line. Small doses of heparin were used to keep the catheters open. On hospital day 11, the patient’s platelet count dropped. A contrast enhanced CT scan showed a thrombus shadow at the pulmonary artery and deep vein thrombosis in the right thigh. Platelets and a therapeutic dose of heparin were administered intravenously. We debrided the necrotic tissue in his ulcers and applied skin grafts. The platelet count failed to rise after these treatments, and the possibility of HIT was considered. When all heparin therapy was stopped on day 43, the platelet count began to rise gradually. The diagnosis of HIT was confirmed by detection of positive anti-heparin-platelet factor 4 complex antibodies in his serum. Because heparin is widely used for a variety of diseases, we should keep in mind that even small doses may evoke undesirable consequences.
