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Bilateral Lower Extremity Gangrene Requiring Amputation Associated with Heparin-Induced Thrombocytopenia

A Case Report

Daniel A. De Ugarte, MD

Todd D. Reil, MD

Bryce D. Beseth, MD

Peter F. Lawrence, MD

Los Angeles, CA

Heparin use, both prophylactically and therapeutically, is prevalent among hospitalized patients. Patients on heparin may develop a thrombocytopenia that is self-limited. Fewer patients develop a heparin-induced thrombocytopenia that can cause severe bleeding and thrombosis owing to intravascular platelet aggregation. The authors present a case report of heparininduced thrombocytopenia in a patient who underwent aortic arch and aortic valve replacement that resulted in bilateral above-knee amputations. The patient developed limb ischemia related to heparin-associated thrombosis, but had a delay in antibody seroconversion. Early and accurate diagnosis of heparin-induced thrombocytopenia requires a high clinical suspicion and may be present despite the absence of serum antibodies.

Vascular and Endovascular Surgery, Vol. 40, No. 2, 161-164 (2006)
DOI: 10.1177/153857440604000212


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