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• Vol.44 No.9
• CLINICA NEUROL, 44: 636−638, 2004
• Vol.44 No.9 contents

Brief Clinical Note

A case of heparin-induced thrombocytopenia that worsened preexisting cerebral infarction

Hiroshi Yaguchi, M.D.¹⁾, Hidetaka Mitsumura, M.D.²⁾, Ritsuko Ozawa, M.D.²⁾, Hironori Sato, M.D.¹⁾ and Kiyoharu Inoue, M.D.²⁾

¹⁾Department of Neurology, The Jikei University Kashiwa Hospital
²⁾Department of Neurology, The Jikei University School of Medicine

A 75-year-old man was admitted to our hospital with dysesthesia of the right lip, dysphagia and gait disturbance. He presented with right Wallenberg syndrome and brain MR image showed a fresh infarction in the right lateral medulla. Therapy with heparin and ozagrel sodium was started. For a time his symptom improved a little, but after 8 days he developed re-infarction, thrombocytopenia and DIC, while being treated with heparin for cerebral infarction. Heparin was discontinued, and these symptoms improved quickly. The clinical course and the positive anti-platelet factor 4-heparin complex antibody suggested that these symptoms were caused by heparin-induced thrombocytopenia (HIT). HIT should be included as a differential diagnosis for progression of ischemic stroke under heparin therapy.

(CLINICA NEUROL, 44: 636−638, 2004)
key words: cerebral thrombosis, thrombocytopenia, disseminated intravascular coagulation, heparin-induced thrombocytopenia, anti-platelet factor 4-heparin complex antibody

(Received: 10-Dec-03)