INTRODUCTION: It has been suggested, that HIT-type-II can occur both after the use of low-molecular-weight and unfractionated heparin. The present study investigates the incidence of HIT-type-II after the use of low molecular weight heparin by reviewing the literature and describes one own case. CASE REPORT: We observed in a 72 year old female patient a HIT-type-II, who received low molecular weight heparin (Clexane 40 o.a.d) after the implantation of an endoprothesis as thrombosis prophylaxis. This occurred on the 9th postoperative day. One year later we performed a second endoprosthesis operation of the contralateral site without complications. With the known HIT-type-II, diagnosed the year before,we used hirudin (Refludan) for thrombosis prophylaxis. RESULT: A critical view on the international literature revealed only a few cases, where a HIT-type-II was caused by the use of low molecular weight heparin. The incidence seems to be much lower than correlated to the use of unfractionated heparin. CONCLUSION: It is possible to suffer from a HIT-type-II after low molecular weight heparin. This study confirms the suspicion that the incidence of a HIT-type-II after low molecular weight is lower than after unfractionated heparin. Therefore the further use of unfractioned heparin for thrombosis prophylaxis has to be questioned and low molecular-weight heparin should be preferred.
INTRODUCTION: It has been suggested, that HIT-type-II can occur both after the use of low-molecular-weight and unfractionated heparin. The present study investigates the incidence of HIT-type-II after the use of low molecular weight heparin by reviewing the literature and describes one own case. CASE REPORT: We observed in a 72 year old female patient a HIT-type-II, who received low molecular weight heparin (Clexane 40 o.a.d) after the implantation of an endoprothesis as thrombosis prophylaxis. This occurred on the 9th postoperative day. One year later we performed a second endoprosthesis operation of the contralateral site without complications. With the known HIT-type-II, diagnosed the year before,we used hirudin (Refludan) for thrombosis prophylaxis. RESULT: A critical view on the international literature revealed only a few cases, where a HIT-type-II was caused by the use of low molecular weight heparin. The incidence seems to be much lower than correlated to the use of unfractionated heparin. CONCLUSION: It is possible to suffer from a HIT-type-II after low molecular weight heparin. This study confirms the suspicion that the incidence of a HIT-type-II after low molecular weight is lower than after unfractionated heparin. Therefore the further use of unfractioned heparin for thrombosis prophylaxis has to be questioned and low molecular-weight heparin should be preferred.