F D Cirisano1, S Lee, J S Greenspoon. 1. Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Abstract
BACKGROUND: During the puerperium, heparin levels, rather than the adjusted partial thromboplastin time test, can be used to identify heparin resistance and guide heparin therapy. CASE: A patient receiving heparin for deep venous thrombosis had artifactual resistance to heparin, with a short adjusted partial thromboplastin time due to elevation of factor VIII. Heparin assay revealed a heparin level above the therapeutic range. CONCLUSION: Direct measurement of heparin concentration and factor VIII activity should be performed when heparin resistance is suspected.
BACKGROUND: During the puerperium, heparin levels, rather than the adjusted partial thromboplastin time test, can be used to identify heparin resistance and guide heparin therapy. CASE: A patient receiving heparin for deep venous thrombosis had artifactual resistance to heparin, with a short adjusted partial thromboplastin time due to elevation of factor VIII. Heparin assay revealed a heparin level above the therapeutic range. CONCLUSION: Direct measurement of heparin concentration and factor VIII activity should be performed when heparin resistance is suspected.
Authors: John A Heit; Brian D Lahr; Tanya M Petterson; Kent R Bailey; Aneel A Ashrani; L Joseph Melton Journal: Blood Date: 2011-09-02 Impact factor: 22.113