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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

Heparin-induced thrombocytopenia developing under invasive pulmonary ventilation for COVID-19 pneumonia

Takashi Ishiguro  Kenji Takano  Takashi Nishida  Hiromi Nakajima  Shun Shibata  Noboru Takayanagi 

Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center

ABSTRACT

A 67-year-old man with diabetes mellitus developed pneumonia with COVID-19 and required invasive pulmonary ventilation from day 17 after onset. Thrombocytopenia was revealed on day 10 after initiation of heparin administration and the heparin-induced thrombocytopenia (HIT) antibody test was positive. Ultrasonography showed left femoral vein thrombosis, and he was diagnosed as having HIT. After heparin was discontinued and edoxaban was started, thrombocytopenia and deep vein thrombosis improved. Anticoagulant therapy is recommended in severe cases of COVID-19. However, because patients with COVID-19 are reported to develop HIT more easily than those with other conditions, the possibility of HIT should be considered and platelet counts monitored in patients with severe COVID-19 who receive heparin therapy and show thrombocytopenia.

KEYWORDS

Coronavirus disease 2019 (COVID-19)  Heparin-induced thrombocytopenia (HIT)  Anticoagulant therapy  Severe case  Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) 

Received 18 Mar 2021 / Accepted 31 May 2021

AJRS, 10(5): 383-387, 2021

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