IJCM  Vol.3 No.1 , January 2012
Catastrophic Complications of Intravenous Line Flushing with Unfractionated Heparin
Heparin-induced thrombocytopenia (HIT) is a clinicopathologic syndrome because diagnosis is based on both clinical symptoms and laboratory data. We report a patient with multiple thromboembolic complications after daily flushing of intravenous line with small amounts of unfractionated heparin (UFH). At day 7 bilateral hemorrhagic infarction of the adrenal glands was misdiagnosed as adrenal adenoma. On day 10 thrombocytopenia was noted and the next day a myocardial infarction complicated by a left ventricular thrombus was diagnosed. On day 12, HIT was suspected. The pre-test probability for HIT according to the 4T-score was high (8/8 points) and detection of antibodies directed against the PF4/heparin-complex by particle gel immunoassay (Titer 1:1024) and ELISA (O.D. 2.784) was strongly positive. HIT can be induced by iv-line flushes with UFH. Arterial and venous thrombotic complications can be present before a clear platelet drop can be recognised.

Cite this paper
G. Colucci, M. Jahns, T. Silzle and L. Alberio, "Catastrophic Complications of Intravenous Line Flushing with Unfractionated Heparin," International Journal of Clinical Medicine, Vol. 3 No. 1, 2012, pp. 36-39. doi: 10.4236/ijcm.2012.31007.
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