HEART's Original [症例] ヘパリン起因性血小板減少症による急性冠閉塞時に血栓吸引を施行し得た1例

症例は81歳,女性.2005年2月に前壁中隔梗塞を発症し,保存的治療の後当院に転院し,心臓カテーテル検査を施行.検査直後胸痛とともに心電図上且II,III,aVFでST上昇を認め再造影したところ,右冠動脈は攣縮とともに血栓による完全閉塞を認め,直ちに血栓吸引を施行し,ステントを留置した.前医入院中に深部静脈血栓症に伴う肺塞栓症があり,検査後に血小板減少を認め,ヘパリン依存性抗体も陽性であり,ヘパリン起因性血小板減少症(HIT)と考えられた.吸引された血栓は血小板成分が主体でフィブリン成分に乏しく,白血球成分は好中球,単核球とともに好酸球を多く含んでおり,通常の急性冠症候群でみられる赤血球成分を...

Full description

Saved in:
Bibliographic Details
Published in心臓 Vol. 38; no. 7; pp. 700 - 704
Main Authors 江角, 仁志, 濱嵜, 裕司, 松山, 高明, 武井, 雅俊, 櫻井, 将之, 片桐, 敬, 太田, 秀一, 酒井, 哲郎
Format Journal Article
LanguageJapanese
Published 公益財団法人 日本心臓財団 2006
Subjects
急性冠閉塞
病理組織学
血栓塞栓症
Online AccessGet full text
ISSN0586-4488
2186-3016
DOI10.11281/shinzo1969.38.7_700

Cover

Abstract 症例は81歳,女性.2005年2月に前壁中隔梗塞を発症し,保存的治療の後当院に転院し,心臓カテーテル検査を施行.検査直後胸痛とともに心電図上且II,III,aVFでST上昇を認め再造影したところ,右冠動脈は攣縮とともに血栓による完全閉塞を認め,直ちに血栓吸引を施行し,ステントを留置した.前医入院中に深部静脈血栓症に伴う肺塞栓症があり,検査後に血小板減少を認め,ヘパリン依存性抗体も陽性であり,ヘパリン起因性血小板減少症(HIT)と考えられた.吸引された血栓は血小板成分が主体でフィブリン成分に乏しく,白血球成分は好中球,単核球とともに好酸球を多く含んでおり,通常の急性冠症候群でみられる赤血球成分を多く含む血栓とは明らかに異なっていた.HITによる冠動脈血栓を組織学的に評価できた稀な症例と考えられた.
AbstractList 症例は81歳,女性.2005年2月に前壁中隔梗塞を発症し,保存的治療の後当院に転院し,心臓カテーテル検査を施行.検査直後胸痛とともに心電図上且II,III,aVFでST上昇を認め再造影したところ,右冠動脈は攣縮とともに血栓による完全閉塞を認め,直ちに血栓吸引を施行し,ステントを留置した.前医入院中に深部静脈血栓症に伴う肺塞栓症があり,検査後に血小板減少を認め,ヘパリン依存性抗体も陽性であり,ヘパリン起因性血小板減少症(HIT)と考えられた.吸引された血栓は血小板成分が主体でフィブリン成分に乏しく,白血球成分は好中球,単核球とともに好酸球を多く含んでおり,通常の急性冠症候群でみられる赤血球成分を多く含む血栓とは明らかに異なっていた.HITによる冠動脈血栓を組織学的に評価できた稀な症例と考えられた.
Author 松山, 高明
武井, 雅俊
片桐, 敬
酒井, 哲郎
太田, 秀一
櫻井, 将之
江角, 仁志
濱嵜, 裕司
Author_xml – sequence: 1
  fullname: 江角, 仁志
  organization: 昭和大学医学部第三内科
– sequence: 1
  fullname: 濱嵜, 裕司
  organization: 昭和大学医学部第三内科
– sequence: 1
  fullname: 松山, 高明
  organization: 昭和大学医学部第二病理
– sequence: 1
  fullname: 武井, 雅俊
  organization: 昭和大学医学部第三内科
– sequence: 1
  fullname: 櫻井, 将之
  organization: 昭和大学医学部第三内科
– sequence: 1
  fullname: 片桐, 敬
  organization: 昭和大学医学部第三内科
– sequence: 1
  fullname: 太田, 秀一
  organization: 昭和大学医学部第二病理
– sequence: 1
  fullname: 酒井, 哲郎
  organization: 昭和大学医学部第三内科
BookMark eNpFkE1LAlEUhi9hkJn_oIW7Vtq9c-fjzlLMMhCEsFXEcJ256oiNMeOmVn5AHxiURVpIpYsIaiNE5KLsx9xmsn_RUFGbcw68z3lfeGdBwKpYDIB5BGMICQQtOkXT2q0gVVZjmMQUTYFwCgQFROQohkgOgCCU_FsUCZkBYccxcxBCoiBVxUFQTyXja9kFJ5KxzYJp0XJk46O7_z5ubUZ484I327x5z5uPk6dnt9f3aneTQc0dHntXb96o5w7bPsvrD7xxwBstr3brA-5e_7Nz6A6uvcuGL_m81z9zT0buyzlvnHqd18ngiNe77rjL6zfID5oD03ladlj4d4fA-nIym0hF05mV1UQ8HS0hItIoUXEe6khRJBXLhm6gvCLkxJwqS5QKsiJAChmToIAlQ9AlQycqo9R_IaLMBJbXcQgs_fiWnCotMG3bNreovaNRu2rqZab916hhoinfA8I_WS9SWytR_AWKCZbz
ContentType Journal Article
Copyright 公益財団法人　日本心臓財団
Copyright_xml – notice: 公益財団法人　日本心臓財団
DOI 10.11281/shinzo1969.38.7_700
DatabaseTitleList
DeliveryMethod fulltext_linktorsrc
EISSN 2186-3016
EndPage 704
ExternalDocumentID article_shinzo1969_38_7_38_700_article_char_ja
GroupedDBID ALMA_UNASSIGNED_HOLDINGS
JSF
KQ8
MOJWN
RJT
ID FETCH-LOGICAL-j184a-893f0c1775936dcd1f72b4b965aa26720a0ee50235d2c5dc89eaa3f0846e2efc3
ISSN 0586-4488
IngestDate Wed Sep 03 06:27:24 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed false
IsScholarly true
Issue 7
Language Japanese
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-j184a-893f0c1775936dcd1f72b4b965aa26720a0ee50235d2c5dc89eaa3f0846e2efc3
OpenAccessLink https://www.jstage.jst.go.jp/article/shinzo1969/38/7/38_700/_article/-char/ja
PageCount 5
ParticipantIDs jstage_primary_article_shinzo1969_38_7_38_700_article_char_ja
PublicationCentury 2000
PublicationDate 2006
PublicationDateYYYYMMDD 2006-01-01
PublicationDate_xml – year: 2006
  text: 2006
PublicationDecade 2000
PublicationTitle 心臓
PublicationTitleAlternate 心臓
PublicationYear 2006
Publisher 公益財団法人 日本心臓財団
Publisher_xml – name: 公益財団法人 日本心臓財団
References 6) Warkentin TE: Heparin-induced thrombocytopenia. Diagnosis and management. Circulation 2004: 110e454e458
1) Warkentin TE, Sheppard JA, Horsewood P, et al: Impact of the patient population on the risk for heparininduced thrombocytopenia. Blood 2000: 96: 1703-1708
2) Yamamoto S, Koide M. Matsuo M. et al: Heparininduced thrombocytopenia in hemodialysis patients. Am J Kidney Dis 1996: 28: 82-85
9) Raskob GE. MSc. George JN: Thrombotic complications of antithrombotic theraphy: A paradox with implications for clinical practice. Ann Intern Med 1997; 127: 839-841
8) Lewis BE, Wallis DE, Berkowitz SD, et al: Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation 2001: 103: 1838-1843
7) Warkentin TE. Kelton JG: Temporal aspect of heparininduced thrombocytopenia. N Engl J Med 2001: 344: 1286-1292
14) Rohrbach MS. Wheatley CL. Gleich GJ: Activation of platelets by eosinophil granule proteins. J Eap Med 1990: 172: 1271-1274
5) Warkentin TE, Kelton JG: A14-year study of heparininduced thrombocytopenia. Am J Med 1996: 101: 502-507
10) Horsewood P. Warkentin TE. Kelton JG: The epitope specificity of heparin-induced thrombocytopenia. Br J Haematol 1996: 95: 161-167
12) Sawaki D. Otani Y. Kobayakawa N. et al: A case of heparin-induced thrombocytopenia with sepsis and congestive heart failure. Circ J 2004: 68: 1215-1218
11) Kelton JG, Smith JW, Warkentin TE, et al Immunoglobulin G from patients with heparin-induced thrombocytopenia binds to a complex of heparin and platelet factor 4. Blood 1994; 83: 3232-3239
3) Chong BH: Heparin-induced thrombocytopenia. Blood Reviews 1988: 2: 108-114
15) Warkentin TE, Greinacher A: Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004:126: 311S-337S
13) Slungaard A, Vercellotti GM. Tran T. et al: Eosinophil cationic granule proteins impair thrombomodulin function. J Clin Invest 1993; 91: 1721-1730
4) Bacsi BS. Palma RD. Visentin GP, et al: Complexes of heparin and platelet factor 4 specifically stimulate T cell from patients with heparin-induced thrombocytopenia/thrombosis. Blood 1999: 94: 208-215
References_xml – reference: 5) Warkentin TE, Kelton JG: A14-year study of heparininduced thrombocytopenia. Am J Med 1996: 101: 502-507
– reference: 15) Warkentin TE, Greinacher A: Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004:126: 311S-337S
– reference: 3) Chong BH: Heparin-induced thrombocytopenia. Blood Reviews 1988: 2: 108-114
– reference: 4) Bacsi BS. Palma RD. Visentin GP, et al: Complexes of heparin and platelet factor 4 specifically stimulate T cell from patients with heparin-induced thrombocytopenia/thrombosis. Blood 1999: 94: 208-215
– reference: 13) Slungaard A, Vercellotti GM. Tran T. et al: Eosinophil cationic granule proteins impair thrombomodulin function. J Clin Invest 1993; 91: 1721-1730
– reference: 10) Horsewood P. Warkentin TE. Kelton JG: The epitope specificity of heparin-induced thrombocytopenia. Br J Haematol 1996: 95: 161-167
– reference: 6) Warkentin TE: Heparin-induced thrombocytopenia. Diagnosis and management. Circulation 2004: 110e454e458
– reference: 8) Lewis BE, Wallis DE, Berkowitz SD, et al: Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation 2001: 103: 1838-1843
– reference: 1) Warkentin TE, Sheppard JA, Horsewood P, et al: Impact of the patient population on the risk for heparininduced thrombocytopenia. Blood 2000: 96: 1703-1708
– reference: 9) Raskob GE. MSc. George JN: Thrombotic complications of antithrombotic theraphy: A paradox with implications for clinical practice. Ann Intern Med 1997; 127: 839-841
– reference: 7) Warkentin TE. Kelton JG: Temporal aspect of heparininduced thrombocytopenia. N Engl J Med 2001: 344: 1286-1292
– reference: 12) Sawaki D. Otani Y. Kobayakawa N. et al: A case of heparin-induced thrombocytopenia with sepsis and congestive heart failure. Circ J 2004: 68: 1215-1218
– reference: 14) Rohrbach MS. Wheatley CL. Gleich GJ: Activation of platelets by eosinophil granule proteins. J Eap Med 1990: 172: 1271-1274
– reference: 2) Yamamoto S, Koide M. Matsuo M. et al: Heparininduced thrombocytopenia in hemodialysis patients. Am J Kidney Dis 1996: 28: 82-85
– reference: 11) Kelton JG, Smith JW, Warkentin TE, et al Immunoglobulin G from patients with heparin-induced thrombocytopenia binds to a complex of heparin and platelet factor 4. Blood 1994; 83: 3232-3239
SSID ssib000871993
ssib005879815
ssib058494393
ssj0000605722
ssib002822027
Score 1.680545
Snippet 症例は81歳,女性.2005年2月に前壁中隔梗塞を発症し,保存的治療の後当院に転院し,心臓カテーテル検査を施行.検査直後胸痛とともに心電図上且II,III,aVFでST上昇を認め再造...
SourceID jstage
SourceType Publisher
StartPage 700
SubjectTerms 急性冠閉塞
病理組織学
血栓塞栓症
Title HEART's Original [症例] ヘパリン起因性血小板減少症による急性冠閉塞時に血栓吸引を施行し得た1例
URI https://www.jstage.jst.go.jp/article/shinzo1969/38/7/38_700/_article/-char/ja
Volume 38
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX 心臓, 2006/07/15, Vol.38(7), pp.700-704
journalDatabaseRights – providerCode: PRVAFT
  databaseName: Open Access Digital Library
  customDbUrl:
  eissn: 2186-3016
  dateEnd: 99991231
  omitProxy: true
  ssIdentifier: ssj0000605722
  issn: 0586-4488
  databaseCode: KQ8
  dateStart: 19690101
  isFulltext: true
  titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html
  providerName: Colorado Alliance of Research Libraries
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR1Na9RANJR68SKKit_swcFDSc3HTmbm4CHZzVIEFaEFQUpIsslhD61oe-mpuwt-UEGr2CpFbQ8i6KUgYg9af0zMWv-F700-NrU9WIVlGGbe17w3mXlvdj4U5aIIAmaJGI-fUU2tm5EG46AVqBTKwrYR8rp8DObadWtiqn71Fr01Mjpd2bU0PxeMhwv7niv5F6tCGdgVT8kewLIlUSiAPNgXUrAwpH9l4wkX3FG54n6jeN-KUIe4jAhGIMp368RxCXcIbY4R1yTcJIIXGT3P2HaecUzicuJQ4gAmJcIhtkZcC_dC2AyrbB3zUOVohLewSjSJIzMOR_isCimXEgBlndiOzBiE8yLjFJRphQUl3JJMBRFQKLAEmApX8hKIOCRYyiNRhCll1lASFKNBBM15CUOig5DNAquR0xGSKehIFKKKll6qreq4S7gWqglIQMNEOV7K5iOiJM6QHXRbScRBihmiYLvgW4iCNSBzI4MHZFMKTVG5Dq_Co55dCa_jT8IL1AKa08KUu1V4u0lsS4pgI8kcHizEqSyFhti713vKb1PyB7U3pBEBw5a9wkC95b3ClE3IhJUsHHtMisFyc0KTEP9Pje0lVJmGKLdUCOKzZkeyDB8yU2FqsKrzqMkr4wWrTIpM0yr-Fcuem947dRsc525ceF2YxUubxk0-zrwSedel6Pkn5w2hPZN7TCaa5hXVeHLR60D4dMhg4Ijino2b1eiD4fbV6uoDLgUOpyfOROUqI3DVBbjvZrmEq1kQ7GT_UxY6yg_nYlsu79MScHM7EPQVG0alDzt5VDmSB581O5P7mDLS8Y8rXTmKXLpXK8aQ2u2fqw9-bC9N15L-y6S_nPQ_JP1PO5-_pGvrg8X3OxuL6eaTwevvg621dHMZYJPux6T3MOktDRbfAUB6f_3XyqN0483gVQ-qAH6w_jx9upV-fZH0ng1Wvu1sPE66q-n2atJ9qwOjE8pUy51sTKj5wyxqR-d1X4UYJ9ZCnTF8DrQdtvWYGUE9EBb1fcNihuZrUUTxJi0Y7Wk75CLyfUCBWCcyojg0TyqjM7Mz0SmlZsUGjYKQB22D1bUYr6byaWzEQdtvB3pgnlauZBrz7mS373gHM_2Z_8Q_qxweLrqeU0bn7s5H5yEMmQsuyM70G5hgAbc
linkProvider Colorado Alliance of Research Libraries
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=HEART%27s+Original+%5B%E7%97%87%E4%BE%8B%5D+%E3%83%98%E3%83%91%E3%83%AA%E3%83%B3%E8%B5%B7%E5%9B%A0%E6%80%A7%E8%A1%80%E5%B0%8F%E6%9D%BF%E6%B8%9B%E5%B0%91%E7%97%87%E3%81%AB%E3%82%88%E3%82%8B%E6%80%A5%E6%80%A7%E5%86%A0%E9%96%89%E5%A1%9E%E6%99%82%E3%81%AB%E8%A1%80%E6%A0%93%E5%90%B8%E5%BC%95%E3%82%92%E6%96%BD%E8%A1%8C%E3%81%97%E5%BE%97%E3%81%9F1%E4%BE%8B&rft.jtitle=%E5%BF%83%E8%87%93&rft.au=%E6%B1%9F%E8%A7%92%2C+%E4%BB%81%E5%BF%97&rft.au=%E6%BF%B1%E5%B5%9C%2C+%E8%A3%95%E5%8F%B8&rft.au=%E6%9D%BE%E5%B1%B1%2C+%E9%AB%98%E6%98%8E&rft.au=%E6%AD%A6%E4%BA%95%2C+%E9%9B%85%E4%BF%8A&rft.date=2006&rft.pub=%E5%85%AC%E7%9B%8A%E8%B2%A1%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%BF%83%E8%87%93%E8%B2%A1%E5%9B%A3&rft.issn=0586-4488&rft.eissn=2186-3016&rft.volume=38&rft.issue=7&rft.spage=700&rft.epage=704&rft_id=info:doi/10.11281%2Fshinzo1969.38.7_700&rft.externalDocID=article_shinzo1969_38_7_38_700_article_char_ja
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0586-4488&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0586-4488&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0586-4488&client=summon