Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2023; 11(26): 6147-6153
Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6147
Rivaroxaban for the treatment of heparin-induced thrombocytopenia with thrombosis in a patient undergoing artificial hip arthroplasty: A case report
Fang-Fang Lv, Mei-Ye Li, Wei Qu, Zhao-Shun Jiang
Fang-Fang Lv, Mei-Ye Li, Wei Qu, Zhao-Shun Jiang, Department of Endocrinology, 960th Hospital of PLA, Jinan 250014, Shandong Province, China
Author contributions: Lv FF performed the data collection and the literature search and wrote the manuscript; Li MY reviewed the literature and edited the manuscript; Qu W and Jiang ZS contributed to the collection of data and guaranteed the integrity of the entire study; All authors read and approved the manuscript.
Informed consent statement: The patient provided informed written consent prior to publication.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Shun Jiang, Doctor, Professor, Department of Endocrinology, 960th Hospital of PLA, No. 25 Shifan Road, Tianqiao District, Jinan 250014, Shandong Province, China. jzs012@163.com
Received: April 15, 2023
Peer-review started: April 15, 2023
First decision: July 7, 2023
Revised: July 13, 2023
Accepted: July 19, 2023
Article in press: July 19, 2023
Published online: September 16, 2023
Abstract
BACKGROUND

Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis, and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice. But one uncommon side effect of low-molecular-weight heparin is heparin-induced thrombocytopenia (HIT), which can develop into thrombosis if not caught early or managed incorrectly.

CASE SUMMARY

We present a case of a patient who underwent hip arthroplasty and experienced thrombocytopenia due to HIT on the 9th d following the application of low-molecular-weight heparin anticoagulation. We did not diagnose HIT in time and applied 1 unit of platelets to the patient, which led to thrombosis. Luckily, the patient recovered following effective and timely surgery and treatment with rivaroxaban.

CONCLUSION

Patients using low-molecular-weight heparin after lower limb surgery need to have their platelet counts regularly checked. If HIT develops, platelet treatment should be given with caution.

Keywords: Low-molecular-weight heparin, Heparin-induced thrombocytopenia with thrombosis, Platelet, Case report

Core Tip: Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis, and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice. But one uncommon side effect of low-molecular-weight heparin is heparin-induced thrombocytopenia. If heparin-induced thrombocytopenia develops, platelet treatment should be given with caution.