• Arch Phys Med Rehabil · Jun 1989

    Case Reports

    Heparin-associated thrombocytopenia and thrombosis syndrome in a rehabilitation patient.

    • M A Young, E D Ehrenpreis, M Ehrenpreis, and S Kirshblum.
    • Albert Einstein College of Medicine/Montefiore Medical Center, Department of PM&R, Bronx, NY 10461.
    • Arch Phys Med Rehabil. 1989 Jun 1;70(6):468-70.

    AbstractHeparin-associated thrombocytopenia and thrombosis (HATT) syndrome is a severe complication of heparin therapy. Since patients admitted for rehabilitation are at high risk for deep-vein thrombosis and pulmonary embolism, prophylactic doses of subcutaneous heparin are frequently used. We report the case of a 73-year-old woman with a history of heparin exposure, admitted to a comprehensive rehabilitation program for management of severe back pain. The patient was started on subcutaneous heparin. After 18 days of hospitalization, she developed marked thrombocytopenia and a massive venous thrombosis in the right lower extremity. On intravenous heparin therapy, the platelet count continued to decline. The thrombocytopenia resolved with discontinuation of heparin. This case illustrates a devastating complication of heparin therapy and emphasizes that physiatrists should be aware of this acute and preventable drug reaction.

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