SUCCESSFUL TREATMENT OF HEPARIN-INDUCED T HROMBOCYTOPENIA (HIT) TYPE-II IN CHILDHOOD WITH RECOMBINANT HIRUDIN

Heparin-induced thrombocytopenia (HIT) type II is a life-threatening c omplication of heparin therapy with venous thrombosis and occlusion of arteries (''white clot syndrome''). So far, in children only a few ca ses of HIT have been reported. The report on a 12-year-old boy who suf fered from venous thrombosis of unknown origin. Thrombolytic therapy i ncluded streptokinase, urokinase and unfractionated heparin. He develo ped thrombocytopenia, thromboembolism of the femoral artery and thromb osis of the vena cava inferior. HIT-antibodies against platelet-factor 4 complex could be demonstrated by ELISA and heparin-induced platelet activation assay, After cessation of heparin anticoagulation was prov ided with a heparinoid and recombinant hirudin. Thereafter he recovere d from venous thrombosis, but amputation of the distal foot at the Cho part line could not be avoided. This case report demonstrates that HIT is not restricted to adults. Furthermore, it strongly suggests that e ven in paediatric patients regular control of platelet counts are nece ssary during heparin application.