Heparin-induced thrombocytopenia is known to produce thrombotic events in addition to bleeding. A large external haematoma developed around the radial arterial line site in a patient with proven HIT while receiving lepirudin. The haematoma masqueraded as continued bleeding and delayed starting renal replacement therapy. This case emphasised the importance of close visual examination of intravascular catheter sites for any evidence of thrombosis.
KeelingDDavidsonSWatsonH. The management of heparin-induced thrombocytopenia. Br J Haematol2006;133: 259–69.
2.
WarkentinTEGreinacherAKosterALincoffAM. Treatment and prevention of heparin-induced thrombocytopenia. Chest2008;133: 340S–80S.
3.
GirtovitisFIBoutouAKIoannidisGMakrisPE. Heparin-induced thrombocytopenia type II. A treatment review. Haema2005;8: 582–89.
4.
KatoriNTanakaKASzlamFLevyJH. The effects of platelet count on clot retraction and tissue plasminogen activator-induced fibrinolysis on thrombelastography. Anesth Analg2005;100: 1781–85.
