CONTINUOUS SUBCUTANEOUS HEPARIN INFUSION FOR TREATMENT OF TROUSSEAUS-SYNDROME

OBJECTIVE: To describe the use of continuous subcutaneous heparin infu sion in the treatment of 2 cases of Trousseau's syndrome. CASE SUMMARI ES: Two patients with metastatic carcinoma presented to the hospital w ith acute coagulopathies consistent with a diagnosis of Trousseau's sy ndrome. In both cases conventional anticoagulant therapies proved to b e impractical and ineffective. DISSCUSION: Considerable literature sug gests that oral anticoagulants such as warfarin are ineffective in the treatment of Trousseau's syndrome. Heparin is more effective for this purpose, although continuous intravenous infusion may prove difficult in the ambulatory setting. Intermittent subcutaneous injections of he parin or low-molecular-weight heparin may not provide reliable anticoa gulation for the entire dosage interval. Although the use of continuou s subcutaneous infusion of heparin has been used for anticoagulation d uring pregnancy, this is the first report of the use of sodium heparin administered by continuous subcutaneous infusion in the treatment of Trousseau's syndrome. CONCLUSIONS: Continuous subcutaneous heparin inf usion may be an effective option for the treatment of Trousseau's synd rome in the ambulatory setting.