Case report

Successful management of acute thromboembolic disease complicated with heparin induced thrombocytopenia type II (HIT II): a case series

Eva Serasli¹ , Maria Antoniadou¹ , Venetia Tsara¹ , Vassilis Kalpakidis² , Angelos Megalopoulos³ , George Trellopoulos³ , Georgia Papaioannou⁴ and Pandora Christaki¹

¹  2nd Department of Chest Medicine, General Hospital G. Papanikolaou, Thessaloniki, Greece

²  Department of Interventional Radiology, General Hospital G. Papanikolaou, Thessaloniki, Greece

³  Cardiovascular Department, General Hospital G. Papanikolaou, Thessaloniki, Greece

⁴  Hematology Department, Papageorgiou General Hospital, Thessaloniki, Greece

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Thrombosis Journal 2008, 6:9doi:10.1186/1477-9560-6-9

Published:	2 July 2008

Abstract

Heparin-induced thrombocytopenia type II (HIT II) is a rare immune-mediated complication of heparin. The diagnosis of HIT is considered in patients exposed to heparin, presenting with thrombocytopenia and thrombosis.

We present two cases with massive pulmonary embolism and HIT, successfully treated with the administration of fondaparinux, an alternative anticoagulant, combined with the insertion of an inferior vena cava filter for the prevention of new thromboembolic events. The two cases supplement the available data of the use of fondaparinux in patients with HIT and pulmonary embolism, before further large studies establish its efficacy and safety in this group of patients. Moreover, the management of these patients reveals the need for future evaluation of the combined therapy of alternative anticoagulant agents with the placement of vena cava filters.