Streptokinase therapy of pulmonary emboli with heparin-associated thrombocytopenia.

A 59-year-old man developed pulmonary emboli with heparin-associated thrombocytopenia. He was treated simultaneously with intravenous streptokinase and oral warfarin sodium. He responded with complete resolution of perfusion defects on lung scan and did not have any hemorrhagic or thrombotic problems. Although optimal therapy for patients with heparin-associated thrombocytopenia and thrombosis is unknown, fibrinolytic therapy may be useful despite thrombocytopenia, provided appropriate resources are available for careful patient monitoring and transfusion therapy.