А case of heparin-induced thrombocytopenia in a patient with a novel coronaviral infection, features of diagnosis and treatment in a naval hospital conditions

2021 ◽  
Vol 7 (3) ◽  
pp. 71-77
Author(s):  
I. D. Shapovalov ◽  
V. E. Makarchenko ◽  
O. Yu. Kartina ◽  
T. L. Belousova
Keyword(s):  
Clinical Practice ◽  
Platelet Activation ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Frequency Of Use ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Naval Hospital

The heparin-induced thrombocytopenia is a severe, potentially life-threatening complication of heparinotherpapia associated with thrombosis, develops as a result of antibody-mediated platelet activation. In the context of the SARS CoV-2 pandemic, the frequency of use of heparin in clinical practice has significantly increased, as a result of which the doctors have become more likely to face this complication. The article presents a review of the literature, describes the pathogenesis, modern algorithms for diagnosis and treatment, demonstrates a clinical case of heparin-induced thrombocytopenia in a patient with the SARS CoV-2, and discusses the features of diagnosis and treatment of this complication in a naval hospital.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals GOUGEROT-HAILEY-HAILEY’S FAMILIAL BENIGN CHRONIC PEMPHIGUS: A CASE REPORT

2019 ◽  
Vol 22 (3-4) ◽  
pp. 86-92
Author(s):  
O. V Grabovskaya ◽  
N. P Teplyuk ◽  
Yuliya V. Kolesova
Keyword(s):  
Case Report ◽  
Family History ◽  
Clinical Case ◽  
Treatment Effectiveness ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Ozone Therapy ◽  
Treatment Methods

The review of the literature on epidemiology, pathogenesis, diagnosis and treatment methods for chronic familial benign pemphigus Gougerot-Haley-Haley, as well as a clinical case of a patient with this disease with family history are presented. The manifestation of the disease occurred at the age of 24, after childbirth. Later there were numerous relapses. Remission was quickly achieved after treatment with antibiotics and oxygen-ozone therapy. In recent years, there has been an increase in the frequency of exacerbations of the disease, and a decrease in treatment effectiveness.

scholarly journals Life-Threatening Intrapulmonary Hemorrhage due to Vancomycin-Induced Thrombocytopenia: A Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Haneen Abdalhadi ◽  
Yazan Fahmawi ◽  
Abhijin Das ◽  
Brian Fouty
Keyword(s):  
Atypical Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Ventilator Associated Pneumonia ◽  
Disseminated Intravascular Coagulopathy ◽  
Heparin Induced Thrombocytopenia ◽  
Platelet Antibodies ◽  
Intravascular Coagulopathy ◽  
Life Threatening ◽  
Uremic Syndrome ◽  
Life Threatening Complication

Thrombocytopenia is a rare and sometimes life-threatening complication of Vancomycin. A 52-year-old male patient with acute kidney injury was treated with Vancomycin for ventilator-associated pneumonia. Three days later, his platelets decreased from 172×109/L to 3×109/L over a 36-hour period. The patient developed significant intrapulmonary bleeding leading to profound hypoxemia. Workup was negative for thrombotic thrombocytopenic purpura, disseminated intravascular coagulopathy, atypical hemolytic uremic syndrome, heparin-induced thrombocytopenia, and autoimmune diseases. All recently started medications were discontinued, and the patient was started empirically on methylprednisolone and intravenous immunoglobulin. The patient’s platelets increased, and his airway bleeding stopped within 48 hours; his platelet count returned to normal by 18 days. Vancomycin-dependent anti-platelet antibodies were identified in the patient’s serum by flow cytometry. Thrombocytopenia is an underrecognized complication of Vancomycin that can lead to life-threating bleeding. Stopping Vancomycin may be sufficient to reverse the thrombocytopenia in patients with normal renal function, but more aggressive measures such as steroids, IVIG, and dialysis may be required to stop bleeding and reverse thrombocytopenia in patients with underlying kidney injury who cannot effectively excrete Vancomycin.

A Flow Cytometric Assay of Platelet Activation Marker P-Selectin (CD62P) Distinguishes Heparin-induced Thrombocytopenia (HIT) from HIT with Thrombosis (HITT)

1999 ◽  
Vol 82 (10) ◽  
pp. 1255-1259 ◽  
Author(s):  
Wenche Jy ◽  
Wei Wei Mao ◽  
Lawrence Horstman ◽  
Peter Valant ◽  
Yeon Ahn
Keyword(s):  
Platelet Activation ◽  
Flow Cytometric Assay ◽  
Laboratory Methods ◽  
Fluorescent Intensity ◽  
Heparin Induced Thrombocytopenia ◽  
Activation Marker ◽  
Flow Cytometric ◽  
Heparin Administration ◽  
Life Threatening ◽  
Positive Results

SummaryHeparin induced thrombocytopenia (HIT) is a well-known complication of heparin administration but usually resolves upon discontinuation without sequelae. However, a small proportion of HIT patients develop thrombosis associated with HIT, designated as HITT, which is often life-threatening and may lead to gangrene and amputations. Existing laboratory methods of confirming HIT/HITT do not distinguish between HIT and HITT. We report a flow cytometric assay of platelet activation marker CD62P to distinguish the effects of addition of HIT vs. HITT plasma to normal blood. Briefly, normal whole blood was incubated with platelet-poor plasma from 12 patients with HITT, 30 with HIT, and 65 controls, in presence and absence of heparin, and expression of CD62P was assayed by flow cytometry. When the ratios of fluorescent intensity of CD62P with heparin divided by that without heparin were compared, HITT plasma induced significantly higher ratios than HIT plasma (HITT ratios ~2.5 vs. HIT ratios ~1.2; p <0.001). Eleven of 12 HITT patients were positive by this test but only 5 of 30 HIT patients were positive (p < 0.0005). In a case of HIT with silent thrombosis, this assay gave a positive results prior to clinically evident thrombosis. In conclusion, this method distinguishes HITT from HIT and may be clinically useful in the detection of HITT, allowing early intervention for preventing catastrophic thrombosis.

scholarly journals Clinical Appearance and Diagnosis of Heparin Induced Thrombocytopenia

2021 ◽  
pp. 466-471
Author(s):  
Gunduz T ◽  
Cakir M ◽  
Bakirci EM ◽  
DEGIRMENCI H
Keyword(s):  
Molecular Weight ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Heparin Induced Thrombocytopenia ◽  
Clinical Appearance ◽  
Treatment Management ◽  
Life Threatening ◽  
Life Threatening Complication

Heparin-İnduced Thrombocytopenia (HIT) is a life-threatening complication that occurs in a small percentage of exposed patients (e.g. unfractionated heparin, Low Molecular Weight Heparin [LMWH]) regardless of dose and treatment management.

scholarly journals Case Report: Heparin-induced thrombocytopenia in a patient with COVID-19

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 704
Author(s):  
Ragia Aly ◽  
Sachin Gupta ◽  
Sorab Gupta ◽  
Balraj Singh ◽  
Abhinav Goyal ◽  
...  
Keyword(s):  
Healthcare Systems ◽  
Dialysis Catheter ◽  
The Novel ◽  
Thromboembolic Complications ◽  
Health Crisis ◽  
Heparin Induced Thrombocytopenia ◽  
High Incidence ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

With the spread of the novel coronavirus disease of 2019 (COVID-19) worldwide and associated high incidence of thromboembolic complications, the use of heparin is on the rise. It therefore is crucial to identify patients with contraindications for heparin. Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of exposure to heparin. We report a 66-year-old woman, who was admitted to the hospital with COVID-19 infection. Her course was complicated by pulmonary embolism and dialysis catheter thrombosis. Our patient had a known history of HIT. Treatment of this patient with heparin would have been catastrophic. The COVID-19 pandemic has overwhelmed healthcare systems and is causing a global health crisis. Nevertheless, this case serves as a reminder of the importance of making every effort to obtain thorough history and review of records of every patient.

scholarly journals Rhabdomyolysis Induced by Coadministration of Fusidic Acid and Atorvastatin: A Case Report and Comprehensive Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Dimitrios Patoulias ◽  
Theodoros Michailidis ◽  
Thomas Papatolios ◽  
Rafael Papadopoulos ◽  
Petros Keryttopoulos
Keyword(s):  
Emergency Department ◽  
Fusidic Acid ◽  
Direct Consequence ◽  
Review Of The Literature ◽  
Limb Weakness ◽  
Comprehensive Review ◽  
Acute Rhabdomyolysis ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Statins are among the most widely prescribed medications worldwide. Acute rhabdomyolysis constitutes a potentially life-threatening side effect regardless of whether statins are administered alone or in combination. The potentially fatal combination of a statin and fusidic acid has been well described in the literature. Acute renal failure can be a direct consequence of this drug-drug interaction. We present a case of a 79-year-old woman who presented to our Emergency Department with a one-week history of limb weakness, myalgia, and inability to stand and walk. The patient had been given fusidic acid to treat Methicillin-Sensitive Staphylococcus Aureus (MSSA) positive dermatitis in the 3 weeks prior to admission, while she continued to take her complete therapeutic regimen, which included atorvastatin. Thus, she developed rhabdomyolysis due to the interaction between fusidic acid and atorvastatin. Herein, we report a life-threatening complication of coadministration of fusidic acid and a statin, which is preventable and predictable. The exact mechanism of the interaction is not fully understood, but coadministration of these two medications must be avoided in clinical practice.

scholarly journals Managing venous thromboembolic events in daily practise: ‘‘time is never enough’’

2016 ◽  
Vol 71 (2) ◽  
Author(s):  
D. Anyfantakis ◽  
E.K. Symvoulakis ◽  
I. Mitrouska
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Practice ◽  
Clinical Case ◽  
Daily Clinical Practice ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Threatening Condition ◽  
Life Threatening

Pulmonary embolism is an insidious life-threatening condition. Its diagnosis represents a challenging topic in daily clinical practice since the recognition and the appropriate management of the condition can lead to the decrease of potentially fatal consequences. We present a clinical case which highlights the necessity for an increased level of ‘surveillance’ from the involved physicians since features of thromboembolic events may be elusive or vague.

scholarly journals Clinical case of Scheuermann-Mau disease – reminiscence of a century-long history

2021 ◽  
Vol 5 ◽  
pp. 111-116
Author(s):  
P.A. Shesternya ◽  
◽  
O.D. Gritsenko ◽  
A.A. Masterova ◽  
A.O. Vasileva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Adult Patient ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
Newly Diagnosed ◽  
Wide Range

Modern strategy for management of spondyloarthritis (SpA) is aimed at the earliest possible diagnosis and treatment of diseases. Emergence of nonradiographic SpA in clinical practice necessitates differential diagnosis of this condition from a wide range of diseases including juvenile spondylodysplasia. The article presents a clinical case of newly-diagnosed Scheuermann-Mau disease in an adult patient

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