• Pharmacotherapy · Mar 2006

    Case Reports

    Treatment of heparin-induced thrombocytopenia with drotrecogin alfa (activated).

    • George J Rubeiz, Christopher M Marrone, and Jacques R Leclerc.
    • Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. grubeiz@ecommunity.com
    • Pharmacotherapy. 2006 Mar 1; 26 (3): 428-34.

    AbstractA patient was administered drotrecogin alfa (activated) in addition to the standard of care for presumed severe sepsis and circulatory shock. Heparin-induced thrombocytopenia (HIT) and hepatic and splenic thromboses complicated her clinical course. Because drotrecogin alfa (activated) treatment is associated with improvement in thrombotic manifestations and thrombocytopenia, it was continued as the sole antithrombotic agent after the HIT became apparent. This approach was chosen despite the patient's severe hepatic and renal dysfunction, which made the use of direct thrombin inhibitors unfavorable. She survived with a reasonable outcome and salvage of her limbs. Although this case suggests a potential role of drotrecogin alfa (activated) in the management of HIT, systematic evaluation of its efficacy in this situation is warranted.

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