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CC BY 4.0 · TH Open 2019; 03(02): e200-e202
DOI: 10.1055/s-0039-1692990
Case Report
Georg Thieme Verlag KG Stuttgart · New York

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

Tamam Bakchoul
1   Transfusion Medicine, University Hospital of Tübingen, Tübingen, Germany
,
Oliver Borst
2   Department of Cardiology and Cardiovascular Medicine, University Hospital of Tübingen, Tübingen, Germany
,
Reimer Riessen
3   Department of Internal Medicine, Medical Intensive Care Unit, University of Tübingen, Tübingen, Germany
,
Josip Lucic
1   Transfusion Medicine, University Hospital of Tübingen, Tübingen, Germany
,
Meinrad Gawaz
2   Department of Cardiology and Cardiovascular Medicine, University Hospital of Tübingen, Tübingen, Germany
,
Karina Althaus
1   Transfusion Medicine, University Hospital of Tübingen, Tübingen, Germany
,
Parwez Aidery
2   Department of Cardiology and Cardiovascular Medicine, University Hospital of Tübingen, Tübingen, Germany
› Author Affiliations Funding This study was supported by grants from the German Research Foundation to T.B. (BA5158/1) and M.G. (KFO-274 and 374031971–TRR 240).
Further Information

Publication History

03 April 2019

22 May 2019

Publication Date:
28 June 2019 (online)

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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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