Heparin-induced thrombocytopenia in a glioblastoma multiforme patient with inferior vena cava filter placement for deep venous thrombosis

• Published in: Neurologia medico-chirurgica Vol. 51; no. 6; p. 445
• Main Authors: Nitta, Naoki, Shitara, Satoshi, Nozaki, Kazuhiko
• Format: Journal Article
• Language: English
• Published: Japan 2011
• Subjects: Anticoagulants - adverse effects; Brain Neoplasms - complications; Brain Neoplasms - surgery; Female; Glioblastoma - complications; Glioblastoma - surgery; Heparin - adverse effects; Humans; Middle Aged; Thrombocytopenia - chemically induced; Thrombocytopenia - complications; Thrombolytic Therapy - methods; Thrombosis - prevention & control; Treatment Outcome; Vena Cava Filters - adverse effects; Vena Cava, Inferior; Venous Thrombosis - complications; Venous Thrombosis - therapy
• ISSN: 1349-8029
• DOI: 10.2176/nmc.51.445

A 58-year-old woman presented with right supplementary motor area glioblastoma multiforme and deep venous thrombosis in her legs. The tumor was resected after temporary inferior vena cava filter placement, considering that increased thrombosis during and after the operation would cause fatal pulmonary embolism. After anticoagulation with unfractionated heparin, thrombocytopenia was aggravated, and computed tomography showed filter catheter-related thrombosis in the inferior vena cava. The diagnosis was heparin-induced thrombocytopenia, and argatroban and urokinase were administered. Thrombolysis with urokinase was completed and the temporary inferior vena cava filter catheter was removed without complication. The present case illustrates the possibility of heparin-induced thrombocytopenia associated with catheter-related thrombosis in neurosurgery.