Autoimmune Heparin-Induced Thrombocytopenia after Transcatheter Aortic Valve Implantation: Successful Treatment with Adjunct High-Dose Intravenous Immunoglobulin

Abstract

We describe a rare case of autoimmune heparin-induced thrombocytopenia after transcatheter aortic valve implantation in which antibodies against platelet factor 4/heparin have led to platelet activation even after heparin cessation, causing a delayed drop in platelet count to below 20 × 10⁹/L. Most interestingly, platelet count rapidly improved after intravenous immunoglobulin treatment and no new thromboembolic complications were observed with further anticoagulation with rivaroxaban.

Keywords

thrombocytopenia - heparin - antibody

Authors' Contributions

T.B., R.R., and O.B. were responsible for the treatment of the patient. K.A. and T.B. performed the experiments and collected the data. P.A., O.B., J.L., K.A., and T.B. analyzed the data, interpreted the results, and wrote the manuscript. All authors read and approved the manuscript.

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