Acute Intracerebral Hemorrhage Associated with Extensive Venous Thrombosis Due to Spontaneous Heparin-Induced Thrombocytopenia After Total Knee Replacement: A Case Report.

Mehdi Kashani, Meghan Brown, Juan Pablo Domecq Graces

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In one paragraph

Article in Hematology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

3 authors.

Mehdi KashaniDepartment of Nephrology, Hypertension, and Critical Care Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.ORCID 0000-0001-6868-6481

Meghan BrownDepartment of Nephrology, Hypertension, and Critical Care Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.

Juan Pablo Domecq GracesDepartment of Nephrology, Hypertension, and Critical Care Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.ORCID 0009-0008-7536-5801

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHeparin-induced thrombocytopenia (HIT) is an autoimmune life-threatening prothrombotic syndrome associated with low platelet count after heparin exposure. Spontaneous heparin-induced thrombocytopenia (S-HIT) is an even less frequent variant of HIT, with only a handful of reports available in the literature, where unexplained thrombocytopenia and/or thrombosis without recent heparin exposure occurs in the setting of positive anti-PF4 antibodies. CASE PRESENTATION: We report a case of S-HIT associated with pulmonary artery embolism, left internal jugular vein, and cerebral vein sinus thrombosis complicated with ipsilateral acute intracerebral hemorrhage. DISCUSSION: It is important to highlight that in patients with otherwise unexplained thrombocytopenia and prior exposure to an inflammatory process, S-HIT should be on the differential.

conclusionsRecognition and avoidance of heparin exposure is the most important aspect of S-HIT, as the management is otherwise similar to HIT.

Indexed as

autoimmune thrombocytopeniabivalirudin anticoagulationcerebral venous sinus thrombosis (CVST)heparin-induced thrombocytopenia (HIT)intracerebral hemorrhageplatelet factor 4 (PF4) antibodiespulmonary embolismspontaneous heparin-induced thrombocytopenia (S-HIT)total knee replacementvenous thrombosis

Identifiers

PMID40126221

DOI10.3390/hematolrep17020012

PMCPMC11932193

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