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Intern Med . Ischemic Stroke Due to Heparin-induced Thrombocytopenia During Severe COVID-19 Infection

tetano

Editor, Senior Moderator
Intern Med


. 2022 Jul 5.
doi: 10.2169/internalmedicine.9531-22. Online ahead of print.
Ischemic Stroke Due to Heparin-induced Thrombocytopenia During Severe COVID-19 Infection


Yasutaka Murakami[SUP] 1 [/SUP], Shuhei Okazaki[SUP] 1 [/SUP], Makoto Yamamoto[SUP] 2 [/SUP], Rei Sakurai[SUP] 1 [/SUP], Jyunki Jinno[SUP] 1 [/SUP], Tatsuhiko Ozono[SUP] 1 [/SUP], Kensuke Ikenaka[SUP] 1 [/SUP], Yasufumi Gon[SUP] 1 [/SUP], Kenichi Todo[SUP] 1 [/SUP], Tsutomu Sasaki[SUP] 1 [/SUP], Haruhiko Hirata[SUP] 2 [/SUP], Akinori Uchiyama[SUP] 3 [/SUP], Hideki Mochizuki[SUP] 1 [/SUP]



Affiliations
Free article

Abstract

A 53-year-old woman with severe coronavirus disease 2019 (COVID-19) pneumonia was admitted and treated with intravenous unfractionated heparin for thromboprophylaxis under general anesthesia with mechanical ventilation. She developed right hemiparesis after hospitalization due to a large hemorrhagic infarction. Her platelet count decreased from 243,000/μL at administration to 121,000/μL. Anti-platelet factor 4-heparin antibody testing was positive according to a latex immunoturbidimetric assay. She was therefore diagnosed with heparin-induced thrombocytopenia. We immediately stopped the heparin and started argatroban; the platelet count recovered, and thrombosis did not relapse. Physicians should consider heparin-induced thrombocytopenia as a cause of ischemic stroke in patients with COVID-19 infection.

Keywords: COVID-19; heparin-induced thrombocytopenia; ischemic stroke.
 
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