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open access

Vol 75, No 3 (2007)
CASE REPORTS
Published online: 2007-07-30
Submitted: 2013-02-22
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The insufficiency of low molecular weight heparin (LMWH) prophylaxis in patients with hereditary antithrombin (AT) deficiency

Małgorzata Dybowska, Paweł Kuca, Renata Gralec, Janusz Burakowski, Witold Z. Tomkowski
Pneumonol Alergol Pol 2007;75(3):278-282.

open access

Vol 75, No 3 (2007)
CASE REPORTS
Published online: 2007-07-30
Submitted: 2013-02-22

Abstract

A 39 year old man with normal, stable blood pressure was admitted to the Cardio-Pulmonary Intensive Care Unit due to diagnosed spiral CT pulmonary embolism (PE) and deep venous thrombosis (DVT). In 1999, a hereditary antithrombin (AT) deficiency was confirmed in the presented case. In 2006, because of a knee injury, the patient was provided with a plaster cast and primary antithrombotic prophylaxis with low molecular weight heparin (LMWH) (80 mg of enoxaparin) was administered subcutaneously once a day (patient’s weight was 80 kg). Despite prophylaxis PE and DVT occurred after 6 weeks of treatment. The patient was successfully treated with unfractioned heparin, repeated infusions of AT concentrate and oral anticoagulants (OA). Transient pulmonary hypertension documented by echocardiography and hemoptysis complicated course of PE. Secondary prophylaxis with OA, and INR maintenance between 2-3, was successfully continued.

Abstract

A 39 year old man with normal, stable blood pressure was admitted to the Cardio-Pulmonary Intensive Care Unit due to diagnosed spiral CT pulmonary embolism (PE) and deep venous thrombosis (DVT). In 1999, a hereditary antithrombin (AT) deficiency was confirmed in the presented case. In 2006, because of a knee injury, the patient was provided with a plaster cast and primary antithrombotic prophylaxis with low molecular weight heparin (LMWH) (80 mg of enoxaparin) was administered subcutaneously once a day (patient’s weight was 80 kg). Despite prophylaxis PE and DVT occurred after 6 weeks of treatment. The patient was successfully treated with unfractioned heparin, repeated infusions of AT concentrate and oral anticoagulants (OA). Transient pulmonary hypertension documented by echocardiography and hemoptysis complicated course of PE. Secondary prophylaxis with OA, and INR maintenance between 2-3, was successfully continued.

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Keywords

inherited thrombophilia; antithrombin deficiency; antithrombotic prophylaxis; pulmonary embolism

About this article
Title

The insufficiency of low molecular weight heparin (LMWH) prophylaxis in patients with hereditary antithrombin (AT) deficiency

Journal

Advances in Respiratory Medicine

Issue

Vol 75, No 3 (2007)

Pages

278-282

Published online

2007-07-30

Bibliographic record

Pneumonol Alergol Pol 2007;75(3):278-282.

Keywords

inherited thrombophilia
antithrombin deficiency
antithrombotic prophylaxis
pulmonary embolism

Authors

Małgorzata Dybowska
Paweł Kuca
Renata Gralec
Janusz Burakowski
Witold Z. Tomkowski

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