Meningococcemia and heparin-induced thrombocytopenia: a dangerous combination

Paediatr Anaesth. 2013 Feb;23(2):197-9. doi: 10.1111/pan.12056. Epub 2012 Oct 15.

Abstract

We present a dramatic case of a patient presenting with disseminated intravascular coagulation related to meningococcal sepsis who developed heparin-induced thrombocytopenia following heparin administration during continuous renal replacement therapy. Association of these two prothrombotic conditions led to severe limbs ischemia and finally to bilateral legs amputation. We stress the importance of suspect heparin-induced thrombocytopenia in intensive care unit patients, especially when an improvement of other coagulation parameters is observed, and heparin therapy was started.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical
  • Anticoagulants / adverse effects*
  • Child, Preschool
  • Disseminated Intravascular Coagulation / chemically induced
  • Disseminated Intravascular Coagulation / complications
  • Disseminated Intravascular Coagulation / physiopathology
  • Heparin / adverse effects*
  • Humans
  • Leg / surgery
  • Male
  • Meningococcal Infections / complications*
  • Meningococcal Infections / physiopathology
  • Platelet Count
  • Platelet Transfusion
  • Regional Blood Flow / physiology
  • Renal Replacement Therapy
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / complications*
  • Thrombocytopenia / physiopathology

Substances

  • Anticoagulants
  • Heparin