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Circulating heparinālike anticoagulants: Case report and review of literature
- Source :
- Transfusion. 61:968-973
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- We report a case of a 56-year-old woman with a history of idiopathic thrombocytopenic purpura (ITP) following splenectomy on mycophenolate mofetil (MMF), who developed moderate bleeding after stopping MMF. Her laboratory testing suggested the presence of an abnormal circulating heparin-like anticoagulant with demonstrable anti-Xa activity. She was initially treated with antifibrinolytic therapy and was subsequently started on MMF alongside intravenous immunoglobulin, which significantly improved her bleeding symptoms. The presence of abnormal circulating heparin-like anticoagulants is a rare cause of coagulopathy. Few cases exist in the literature, with nearly all occurring in the setting of hematologic or solid-organ malignancy. The mechanism by which these endogenous anticoagulants develop is unclear. Clinical manifestations range from mild bleeding and bruising to life-threatening hemorrhage refractory to conventional therapy. Diagnosis of a heparin-like anticoagulant is based on coagulation testing as well as exclusion of other exogenous anticoagulants, acquired inhibitors, and/or factor deficiencies.
- Subjects :
- medicine.medical_specialty
Antifibrinolytic
business.industry
medicine.drug_class
medicine.medical_treatment
Immunology
Anticoagulant
Splenectomy
Immunosuppression
Hematology
030204 cardiovascular system & hematology
medicine.disease
Malignancy
Thrombocytopenic purpura
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Coagulopathy
Coagulation testing
Immunology and Allergy
business
030215 immunology
Subjects
Details
- ISSN :
- 15372995 and 00411132
- Volume :
- 61
- Database :
- OpenAIRE
- Journal :
- Transfusion
- Accession number :
- edsair.doi...........6fde0d382b778324c94a855ac074dc65