• Internal medicine · Sep 2022

    Case Reports

    Ischemic Stroke Due to Heparin-induced Thrombocytopenia During Severe COVID-19 Infection.

    • Yasutaka Murakami, Shuhei Okazaki, Makoto Yamamoto, Rei Sakurai, Jyunki Jinno, Tatsuhiko Ozono, Kensuke Ikenaka, Yasufumi Gon, Kenichi Todo, Tsutomu Sasaki, Haruhiko Hirata, Akinori Uchiyama, and Hideki Mochizuki.
    • Department of Neurology, Osaka University Graduate School of Medicine, Japan.
    • Intern. Med. 2022 Sep 15; 61 (18): 2797-2801.

    AbstractA 53-year-old woman with severe coronavirus disease 2019 (COVID-19) pneumonia was admitted and treated with intravenous unfractionated heparin for thromboprophylaxis under general anesthesia with mechanical ventilation. She developed right hemiparesis after hospitalization due to a large hemorrhagic infarction. Her platelet count decreased from 243,000/μL at administration to 121,000/μL. Anti-platelet factor 4-heparin antibody testing was positive according to a latex immunoturbidimetric assay. She was therefore diagnosed with heparin-induced thrombocytopenia. We immediately stopped the heparin and started argatroban; the platelet count recovered, and thrombosis did not relapse. Physicians should consider heparin-induced thrombocytopenia as a cause of ischemic stroke in patients with COVID-19 infection.

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