Heparin induced thrombocytopenia and re-thrombosis associated with warfarin and fondaparinux in a child.

Full Abstract

An 11-year-old female developed heparin induced thrombocytopenia (HIT) with thrombosis during therapy for lower extremity deep vein thrombosis and pulmonary embolism. Transition from bivalirudin, a direct thrombin inhibitor (DTI), to warfarin resulted in extensive re-thrombosis, and fondaparinux therapy similarly failed. She was then treated with argatroban, and transitioned successfully to warfarin after 9 weeks. The risk of re-thrombosis was ultimately reduced by allowing time for the thrombogenic potential to abate. The argatroban/warfarin transition was monitored with chromogenic factor X levels. This case highlights several difficult problems in pediatric thrombosis. (c) 2009 Wiley-Liss, Inc.

Author information

Author/s: Maurer, Scott H (SH); Wilimas, Judith A (JA); Wang, Winfred C (WC); Reiss, Ulrike M (UM);

Affiliation: Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. scott.maurer(-atsign-)stjude.org

Journal and publication information

Publication Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't

Journal: Pediatric blood & cancer (Pediatr Blood Cancer), published in United States. (Language: eng)

Reference: 2009-Sep; vol 53 (issue 3) : pp 468-71

Dates: Created 2009/07/20; Completed 2009/07/31;

PMID: 19415734, status: MEDLINE (last retrieval date: 8/21/2009, IMS Date: )

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