North Clin Istanb. 2021; 8(4): 402-404 | DOI: 10.14744/nci.2020.37531

Low-molecular-weight heparin-associated multiple digital necrosis in a patient as a result of heparin-induced thrombocytopenia syndrome

Fatih Kabakas¹, Meric Ugurlar², Ozge Yapici Ugurlar³, Yesim Bicer^4
1Department of Hand Surgery, Gebze Medical Park Hospital, Kocaeli, Turkey
²Department of Orthopaedics and Traumatology, Istinye University Faculty of Medicine, Bahcesehir LIV Hospital, Istanbul, Turkey
³Department of Radiology, University of Medical Sciences, Okmeydani Training and Research Hospital, Istanbul, Turkey
⁴Department of Anaesthesiology, Gebze Medical Park Hospital, Kocaeli, Turkey

Heparin-induced thrombocytopenia syndrome (HITS) is a rare complication of low-molecular-weight heparin (LMWH). It is an autoimmune-mediated side effect of LMWH which is caused by platelet-activating antibodies that recognize platelet factor-4/heparin complexes. Although HITS often leads to thrombosis in large veins and arteries, it can be presented as microvascular thrombosis. In this article, we report a case of HITS complicated with multiple digital necrosis after administration of LMWH.

Keywords: Heparin, heparin-induced thrombocytopenia; low-molecular weight heparin; thrombocytopenia.

---

Düþük moleküler aðýrlýklý heparin sonucu geliþen heparin kaynaklý trombositopeni sendromuna baðlý çoklu parmak nekrozu

Fatih Kabakas¹, Meric Ugurlar², Ozge Yapici Ugurlar³, Yesim Bicer^4
1Gebze Medical Park Hastanesi, El Cerrahisi Kliniði, Kocaeli
²Ýstinye Üniversitesi Týp Fakültesi, Bahçeþehir LIV Hastanesi, Ortopedi ve Travmatoloji Anabilim Dalý, Ýstanbul
³Okmeydaný Eðitim ve Araþtýrma Hastanesi, Týp Bilimleri Üniversitesi, Radyoloji Anabilim Dalý, Ýstanbul
⁴Gebze Medical Park Hastanesi, Anesteziyoloji Kliniði, Kocaeli

Heparin kaynaklý trombositopeni sendromu (HKTS) düþük moleküler aðýrlýklý heparinin (DMAH) nadir bir komplikasyonudur. DMAH’nin trombosit faktör-4 / heparin komplekslerini tanýyan trombosit aktive edici antikorlarýn neden olduðu otoimmün aracýlý bir yan etkisidir. Her ne kadar HKTS büyük venlerde ve arterlerde tromboza yol açsa da, mikrovasküler tromboza da neden olabilmektedir. Bu yazýda, DMAH uygulanmasýndan sonra çoklu parmak nekrozu ile komplike olmuþ bir HKTS vakasýný sunmaktayýz. (NCI-2019-0282.R2)

Anahtar Kelimeler: Heparin, heparin kaynaklý trombositopeni sendromu; trombositopeni; düþük moleküler aðýrlýklý heparin.

---