Abstract
We report on a 15-year-old girl referred to us for dyspnea. Investigations revealed multiple pulmonary emboli originating from iliac vein thrombosis. As under heparin therapy, d-dimers rose again and the thrombus grew significantly in size while platelet count decreased by >30%. A diagnosis of heparin-induced thrombocytopenia (HIT) type II was suspected, heparin-treatment was stopped and lepirudin therapy was started successfully at a doses of 0.15 mg/kg bw/hr.
MeSH terms
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Adolescent
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Anticoagulants / adverse effects*
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Anticoagulants / therapeutic use
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Diagnosis, Differential
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Dose-Response Relationship, Drug
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Female
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Fibrinolytic Agents / therapeutic use*
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Heparin / adverse effects*
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Heparin / therapeutic use
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Hirudins
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Humans
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Iliac Vein*
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Magnetic Resonance Angiography
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Magnetic Resonance Imaging
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Pulmonary Embolism / diagnosis
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Pulmonary Embolism / drug therapy*
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Recombinant Proteins / therapeutic use
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Recurrence
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Thrombocytopenia / chemically induced*
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Thrombosis / diagnosis
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Thrombosis / drug therapy*
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Tomography, X-Ray Computed
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Ultrasonography, Doppler
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Vena Cava, Inferior
Substances
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Anticoagulants
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Fibrinolytic Agents
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Hirudins
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Recombinant Proteins
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Heparin
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lepirudin