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©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 28, 2008; 14(28): 4576-4579
Published online Jul 28, 2008. doi: 10.3748/wjg.14.4576
Published online Jul 28, 2008. doi: 10.3748/wjg.14.4576
Cerebral venous thrombosis and heparin-induced thrombocytopenia in an 18-year old male with severe ulcerative colitis
Gudrun Scheving Thorsteinsson, Department of Pediatrics, Karolinska University Hospital and CLINTEC, Karolinska Institutet, Stockholm Se-141 86, Sweden
Maria Magnussson, Pediatric Coagulation Unit, Karolinska University Hospital and CLINTEC, Karolinska Institutet, Stockholm Se-141 86, Sweden
Lena M Hallberg, Division of Radiology, Karolinska University Hospital and Karolinska Institutet, Stockholm Se-141 86, Sweden
Nils Gunnar Wahlgren, Clinical Neuroscience Unit, Karolinska University Hospital and Karolinska Institutet, Stockholm Se-141 86, Sweden
Fredrik Lindgren, Petter Malmborg, Thomas H Casswall, Division of Paediatric Gastroenterology, Hepatology & Nutrition, Karolinska University Hospital and CLINTEC, Karolinska Institutet, Se-141 86 Stockholm, Sweden
Author contributions: Lindgren F and Malmborg P took care of the patient. Thorsteinsson GS took care of the patient and wrote the paper together with Magnussson M who was responsible for the coagulation part and Casswall TH the principal investigator. Hallberg LM analyzed the radiology part and Wahlgren NG analyzed the neurology part.
Correspondence to: Thomas H Casswall, MD, PhD, Division of Paediatric Gastroenterology, Hepatology & Nutrition, B57 Karolinska University Hospital Stockholm Se-141 86, Sweden. thomas.casswall@ki.se
Telephone: +46-8-58581464
Fax: +46-8-58581410
Received: April 22, 2008
Revised: June 6, 2008
Accepted: June 13, 2008
Published online: July 28, 2008
Revised: June 6, 2008
Accepted: June 13, 2008
Published online: July 28, 2008
Abstract
The risk of thromboembolism is increased in inflammatory bowel disease and its symptoms may be overlooked. Furthermore, its treatment can be complex and is not without complications. We describe a case of an adolescent boy who developed a cerebral sinus venous thrombosis during a relapse of his ulcerative colitis and who, while on treatment with heparin, developed heparin-induced thrombocytopenia (HIT). The treatment was then switched to fondaparinux, a synthetic and selective inhibitor of activated factor X.
Keywords: Inflammatory bowel disease, Ulcerative colitis, Cerebral venous thrombosis, Heparin-induced thrombocytopenia, Fondaparinux