A case report of serious heparin-induced thrombocytopenia after the operation for the uterine endometrial carcinoma

Abstract

This report describes the case of a patient who died of serious heparin-induced thrombocytopenia (HIT) associated with thrombosis after surgery for endometrial cancer of the uterus. After the initial surgery, she had to have another operation the following day due to the incidence of intraperitoneal bleeding. Despite the accompanying atrial fibrillation, an ordinary recovery course was observed. On the 14th day after the second operation, however, unexpectedly thrombocytopenia and multi-organ failure became apparent. Suspecting disseminated intravascular coagulation (DIC), subsequent blood anticoagulation was applied, but the patient died the following day. Results of the anti-heparin PF4 complexes test and the platelet aggregation test using her frozen serum revealed that the incidence of HIT in this case was due not to the danaparoid sodium used for the treatment, but a small amount of heparin sodium present in the vessel catheter used for the prevention of blood coagulation. Since heparin sodium is widely employed by many Japanese gynecologists and obstetricians, they should be aware of the fact that even a very small quantity of heparin sodium can invite such undesirable consequences. [Adv Obstet Gynecol, 57 (3) : 279-283, 2005 (H17.8)]