Fondaparinux used for severe heparin induced thrombocytopenia with subacute instent thrombosis

Abstract

Heparin induced thrombocytopenia (HIT) is an immune mediated event that may result in life and limb threatening complications. We report a 52 year old diabetic woman with subacute instent thrombosis and severe heparin induced thrombocytopenia treated successfully with fondaparinux. Not only platelet count returned to normal but also thromboembolic or hemorrhagic events were prevented under treatment. The low rate of de novo antibody formation and the scarce cross-reactivity with HIT antibodies offer fondaparinux as a relatively safe alternative anticoagulant agent for use in patients with HIT. Fondaparinux should be kept in mind in severe HIT if direct thrombin inhibitors are unavailable.