Apparent heparin resistance in a patient with infective endocarditis secondary to elevated factor VIII levels

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• 作者：Ramya Thota (1) ramyathota1@gmail.com
  Apar Kishor Ganti (2) aganti@unmc.edu
  Shanmuga Subbiah (2) ssubbiah@gmail.com
• 关键词：Apparent heparin resistance &#8211 ; Infective endocarditis &#8211 ; Elevated factor VIII levels
• 刊名：Journal of Thrombosis and Thrombolysis
• 出版年：2012
• 出版时间：July 2012
• 年：2012
• 卷：34
• 期：1
• 页码：132-134
• 全文大小：114.2 KB
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• 作者单位：1. Internal Medicine Resident PGY3, Creighton University, 601 N 30th Street, Omaha, NE 68131, USA2. Division of Oncology-Hematology, VA Nebraska Western Iowa Health Care System, 4001 Woolworth Ave, Omaha, NE 68131, USA
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Hematology
  
• 出版者：Springer Netherlands
• ISSN：1573-742X

文摘

Heparin resistance (HR) is defined as increasing requirements of heparin to maintain a therapeutic activated partial thromboplastin time (aPTT). It is commonly associated with antithrombin deficiency, increased heparin clearance and elevations in heparin binding proteins. Elevated factor VIII levels can cause decrease the aPTT levels (anticoagulant effect) without disturbing heparin activity measured by anti-Xa assay (antithrombotic effect) leading to an apparent heparin resistant state rather than a true heparin resistance. We highlight the importance of increasing awareness of apparent HR and early distinction from true resistance to avoid major life threatening hemorrhagic complications. We hereby report an unusual case of heparin resistance due to increased factor VIII levels in an elderly male with infective endocarditis.