Case Report
Cutaneous Microangiopathic Thrombosis Complicated by Pyoderma Gangrenosum in Post-Cardiac Surgery Heparin-Induced Thrombocytopaenia

https://doi.org/10.1016/j.hlc.2007.12.007Get rights and content

Thrombotic cutaneous gangrene is a rare complication of heparin-induced thrombocytopaenia after cardiac surgery. We report a case and discuss management issues with cardiopulmonary bypass for cardiac surgery in this condition.

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Discussion

Heparin is a hetereogenous mixture of linear chain sulphated polyanionic glycosaminoglycans. It exhibits its anticoagulant properties by binding to factor X, which participates in the conversion of prothrombin to thrombin. Thrombin converts fibrinogen to fibrin in the final pathway of the coagulation cascade.

Heparin induced thrombocytopaenia is a clinicopathological syndrome characterised by pathogenic antibodies of immunoglobulin G class against neoepitopes on multimolecular complexes of PF4

Acknowledgement

We thank Dr. Moira J. Finlay for the preparation of the pathology slides.

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