Challenging anticoagulation cases: A case of acute pulmonary embolism in a patient with chronic thrombocytopenia

Kerstin de Wit; Lori-Ann Linkins

doi:10.1016/j.thromres.2020.11.035

Challenging anticoagulation cases: A case of acute pulmonary embolism in a patient with chronic thrombocytopenia

Thromb Res. 2021 Feb:198:83-85. doi: 10.1016/j.thromres.2020.11.035. Epub 2020 Dec 3.

Authors

Kerstin de Wit¹, Lori-Ann Linkins²

Affiliations

¹ Department of Medicine, McMaster University, Hamilton, Canada. Electronic address: [email protected].
² Department of Medicine, McMaster University, Hamilton, Canada.

PMID: 33302211
DOI: 10.1016/j.thromres.2020.11.035

Abstract

We present a case of acute pulmonary embolism in a patient with myelofibrosis and thrombocytopenia. The patient had a history of portal vein thrombosis and had taken warfarin for the past six years. At the time of his pulmonary embolism diagnosis, his INR was 1.5 and platelet count 58 × 10⁹/L. This article discusses how to balance the risk of thrombosis against the risk of bleeding, and reviews the options for pulmonary embolism treatment including transition to low-molecular-weight heparin, direct oral anticoagulants and/or inferior vena cava filters.

Keywords: Anticoagulation; Pulmonary embolism; Thrombocytopenia.

Publication types

Case Reports
Review

MeSH terms

Anticoagulants / therapeutic use
Humans
Pulmonary Embolism* / complications
Pulmonary Embolism* / drug therapy
Thrombocytopenia* / complications
Thrombocytopenia* / drug therapy
Vena Cava Filters*
Venous Thrombosis*

Substances

Anticoagulants