Anticoagulant-induced pseudothrombocytopenia occurring after transcatheter arterial embolization for hepatocellular carcinoma

Jpn J Clin Oncol. 2006 Aug;36(8):527-31. doi: 10.1093/jjco/hyl054. Epub 2006 Jun 22.

Abstract

Pseudothrombocytopenia (PTCP) is the in vitro phenomenon of anticoagulant-activated platelet agglutination that results in spuriously low platelet counts. We report the case of a 65-year-old man with EDTA- and sodium citrate-dependent PTCP occurring after transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) due to hepatitis C cirrhosis. Invasion of the portal and hepatic veins by HCC formed severe trans-tumoral arterio-venous shunts that were effectively treated by TAE. Two days after the therapy, PTCP was seen on blood count and continued for 4 months. The patient received unnecessary treatment for disseminated intravascular coagulation (DIC) until the diagnosis of PTCP was established. PTCP is a rare complication but should be considered after TAE for HCC; lack of recognition may lead the physician to misdiagnosis and patient mismanagement.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibiotics, Antineoplastic / administration & dosage
  • Anticoagulants / adverse effects*
  • Blood Platelets / drug effects
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Disseminated Intravascular Coagulation / diagnosis
  • Edetic Acid / adverse effects
  • Embolization, Therapeutic / adverse effects*
  • Epirubicin / administration & dosage
  • Hepatitis C / complications
  • Humans
  • Liver Cirrhosis / complications
  • Liver Neoplasms / blood
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Male
  • Neoplasm Invasiveness
  • Platelet Count
  • Portal Vein / pathology
  • Thrombocytopenia / diagnosis*
  • Thrombocytopenia / etiology

Substances

  • Antibiotics, Antineoplastic
  • Anticoagulants
  • Epirubicin
  • Edetic Acid