Prevention of venous thromboembolic complications and heparin-induced thrombocytopenia in patient with acute inflammatory polyneuropathy (Guillain-Barre syndrome)

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The case of severe thrombocytopenia caused by direct anticoagulant therapy, immunologically confirmed in patient with Guillain-Barre syndrome, is presented. The clinical presentation was characterized by acute peripheral tetraparesis, accompanied by multiple embologenic thrombosis in deep venous system of shanks. As a result of direct anticoagulant treatment, improvement of ultrasonic image was demonstrated. At the same time the decay of the thrombocytes level and development of haemorrhagic syndrome were observed. The assay of coagulation factors didn’t demonstrate consumption coagulopathy. The results of the bone marrow examination excluded the oncological process in haematopoietic system. Considering that the thrombocytopenia developed exactly 10 days after the onset of the direct anticoagulant therapy, the analysis of the antibodies to the platelet factor 4/heparin complex was performed; the result was positive. Withdrawal of fraxiparine and implementation of plasmapheresis to eliminate the antibodies improved the patient’s condition. The presented case demonstrates the necessity of regular control of all parts of haemostasis, because treatment with remedies intended to correct the coagulation system may cause itself strong hemorheological disorders.


About the authors

Michail A. Piradov

Research Center of Neurology

ORCID iD: 0000-0002-6338-0392

D. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director

Russian Federation, 125367, Russia, Moscow, Volokolamskoye shosse, 80

V. M. Gorodetsky

Research Center of Hematology, Ministry of Health and Social Development

Russian Federation, Moscow

Yulia V. Ryabinkina

Research Center of Neurology

ORCID iD: 0000-0001-8576-9983

D. Sci. (Med.), Head, Intensive care unit department

Russian Federation, 125367, Russia, Moscow, Volokolamskoye shosse, 80

G. M. Galstyan

Research Center of Hematology, Ministry of Health and Social Development

Russian Federation, Moscow

A. A. Khoroshun

Research Center of Neurology

Author for correspondence.
Russian Federation, Moscow


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Copyright (c) 2012 Piradov M.A., Gorodetsky V.M., Ryabinkina Y.V., Galstyan G.M., Khoroshun A.A.

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