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Article in Japanese
Abstract
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
Copyright © The Japanese Respiratory Society All Rights Reserved.