Extra-Bad Blood🩸Vessel Dz in #COVID19:
1. Immunogenic HITT (heparin-ind thrombocytopenia & thrombosis) NOT from heparin but #Covid itself. Bilateral arterial clots.
2. TSS (toxic shock synd) + #COVID - nightmarish clotting in legs/arms = like burns
#MedTwitter #Nurse #Vaxx
1. Immunogenic HITT (heparin-ind thrombocytopenia & thrombosis) NOT from heparin but #Covid itself. Bilateral arterial clots.
2. TSS (toxic shock synd) + #COVID - nightmarish clotting in legs/arms = like burns
#MedTwitter #Nurse #Vaxx
1/ Since others asked, our diagnosis of “spontaneous immunogenic HITT” was made by positive HIT ELISA (an immunoassay) showing the presence of anti-PF4 IgG antibodies even though he had not been (past or present) on heparin. This in setting of #COVID19.
2/ He also had an abnormal functional assay of platelet-activating capacity of PF4/heparin-Ab complexes, though there are slight differences in results of his assay vs. typical HIT. He now has 2 problems (#COVID & HIT) causing potentially life-threatening arterial thrombosis.
3/fin
We treated him w bivalirudin and he will ultimately be on a DOAC. D-dimer & fibrinogen have been used in these situations to assess response to HIT-directed Tx, though there are no published guidelines on this.
We treated him w bivalirudin and he will ultimately be on a DOAC. D-dimer & fibrinogen have been used in these situations to assess response to HIT-directed Tx, though there are no published guidelines on this.
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