A case of unsuccessful treatment of heparin-induced thrombocytopenia (HIT) with fondaparinux

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine; Meyers Primary Care Institute

Publication Date


Document Type



Thrombocytopenia; Heparin; Anticoagulants


Cardiovascular Diseases | Health Services Research | Primary Care


Heparin-induced thrombocytopenia (HIT) is a rare immune-mediated complication associated with unfractionated heparin and to a lesser extent with low-molecular weight heparins. The American College of Chest Physicians recommends treating patients with suspected HIT with a non-heparin product regardless if thrombosis is present. The direct thrombin inhibitors are the preferred agents for the treatment of acute HIT (lepirudin, argatroban [Grade 1C]). Fondaparinux is also suggested as an alternative with a lower level of evidence (Grade 2C). The evidence supporting the use of fondaparinux in the treatment of HIT is limited, but the evidence of fondaparinux causing HIT is even less. We present a case of a patient who developed complications with fondaparinux when used in the acute setting of HIT.

DOI of Published Version



Miranda AC, Donovan JL, Tran MT, Gore J. Unsuccessful treatment of heparin induced thrombocytopenia with fondaparinux. J Thromb Thrombolysis 2012;33(1):133-135. DOI: 10.1007/s11239-011-0641-2

Journal/Book/Conference Title

Journal of thrombosis and thrombolysis

Related Resources

Link to article in PubMed

PubMed ID