Heparin-induced Thrombocytopenia During Multiple Extracorporeal Mechanical Support for Fulminant Myocarditis: A Case Report with a Literature Review

Heparin-induced thrombocytopenia (HIT) is a potentially fatal complication of heparin therapy, particularly during extracorporeal mechanical support requiring anticoagulation. We report the case of a 57-year-old woman with fulminant myocarditis complicated by acute kidney injury who was transferred while receiving extracorporeal membrane oxygenation and continuous renal replacement therapy with unfractionated heparin. After transfer, a rapid platelet decline and repeated circuit occlusions raised a strong suspicion of HIT based on the 4Ts score. Heparin was replaced with nafamostat mesilate or argatroban, and HIT antibodies were detected. Both bleeding and thrombotic complications occurred during intensive care, thus reflecting the complexity of managing critically ill patients receiving multiple extracorporeal mechanical supports.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Fulminant myocarditis on ECMO and CRRT complicated by HIT with rapid platelet decline and repeated circuit occlusion; heparin replaced with nafamostat mesilate or argatroban, illustrating the complexity of HIT management during multi-modal extracorporeal support.

Leech-derived molecules this paper discusses, each with a full profile in the ASH compound registry:

Узнайте, как это исследование связано с клинической практикой

More peer-reviewed studies in Клинические исследования.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Reverse Sural Flap Venous Congestion Successfully Managed With Enoxaparin in a Male Patient With a Traumatic Foot Crush Injury: A Case Report — Velasco-Bustamante J et al. (2026)
• Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury — Ünal K et al. (2026)
• Efficacy of Medicinal Leech Therapy in Diverse Clinical Applications: A Comprehensive Study from Azerbaijan — Farzali S et al. (2025)
• HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW — Heinz P et al. (2020)
• Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review — Foppiani J et al. (2024)
• Hirudotherapy in Wound Healing — Nair H et al. (2022)

Browse all ASH-analysed research →