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To analyze the anticoagulant treatment of patients with low molecular weight heparin-induced severe type II thrombocytopenia complicated by multi-site embolism, and to provide reference for rational use of anticoagulant drugs in clinic.
Clinical pharmacists participated in the diagnosis and treatment of a patient with heparin-induced thrombocytopenia(HIT) with multiple thrombus. According to the patient’s pathophysiology, auxiliary examination and other conditions, combined with literature review and individualized medication monitoring, they assisted in formulating and optimizing the anticoagulant treatment plan, improving the quality of pharmaceutical care, and promoting clinical rational drug use.
The clinical pharmacist assisted in identifying the cause of thrombocytopenia, with a 4T’s HIT score of 7 (indicating high probability of HIT) and positive HIT antibody(HIT-Ab) (6.2 U·mL-1). Following argatroban anticoagulation therapy, the patient’s blood platelet count (PLT) improved from 11 to 87 ×10 ·L-1, while D-dimer levels peaked at 60.08 mg·L-1 FEU before declining to 30.60 mg·L-1 FEU. Activated partial thromboplastin time (APTT) remained stable at approximately 50 seconds. No new thrombotic or hemorrhagic events occurred, and the clinical outcome was favorable.
Although low molecular weight heparin-induced thrombocytopenia is rare, it still needs clinical attention. Clinical pharmacists can assist physicians in formulating individualized treatment plans for patients from the perspective of pharmaceutical professionals to ensure the rationality of clinical drug use.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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