{
  "abstract": "An elderly man underwent hip fracture surgery with pre-/postoperative heparin anticoagulation; the platelet count fell to 5×109/L (nadir); haematopathology blood film review identified leucoerythroblastosis (circulating normoblasts, leucocyte left-shift) and schistocytosis (red cell fragments). Although screening platelet factor 4 (PF4)/heparin enzyme-immunoassay for heparin-induced thrombocytopenia (HIT) antibodies yielded a strong-positive result, the confirmatory serotonin-release assay gave an atypical profile (strong serum-induced serotonin-release but only partial inhibition by platelet Fc receptor-blocking monoclonal antibody). Bilateral lower-limb deep-vein thrombosis prompted treatment with therapeutic-dose fondaparinux and high-dose intravenous immunoglobulin (IVIG) for presumptive ‘autoimmune HIT’ (aHIT), that is, HIT featuring both heparin-dependent and heparin-independent platelet-activating anti-PF4/heparin antibodies. Persistent thrombocytopenia, recurrent fibrinogen decrease and d-dimer increase indicated refractoriness to IVIG, with pulmonary embolism also identified; ultimately, additional IVIG was followed by complete recovery. Further laboratory evaluation confirmed a diagnosis of severe aHIT. A novel finding was the transient appearance of leucoerythroblastosis, compatible with overt disseminated intravascular complicating severe aHIT.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, McMaster University, Hamilton, Ontario, Canada",
    "Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada",
    "Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ali Eshaghpour"
    },
    {
      "affs": [
        0
      ],
      "name": "Conor Bell"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ishac Nazy"
    },
    {
      "affs": [
        2
      ],
      "name": "Theodore Earl Warkentin",
      "orcid": "0000-0002-8046-7588"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0990cw2n6r7kd.bib",
  "cited_by": 0,
  "doi": "10.1136/bcr-2026-275907",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711304/",
  "id": "0990cw2n6r7kd",
  "issns": [
    "1757-790X"
  ],
  "landing_url": "https://doi.org/10.1136/bcr-2026-275907",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "heading",
      "Haematology"
    ],
    [
      "openalex",
      "2746|Heparin-Induced Thrombocytopenia and Thrombosis"
    ]
  ],
  "openalex": "W7223262095",
  "pdf_url": "https://casereports.bmj.com/content/bmjcr/19/10/e275907.full.pdf",
  "pmcid": "PMC13711304",
  "pmid": "42919608",
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/0990cw2n6r7kd.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:06Z",
      "native_id": "PMC13711304",
      "source": "pmc",
      "url": "https://doi.org/10.1136/bcr-2026-275907"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Heparin-Induced Thrombocytopenia and Thrombosis",
      "subfield": "surgery"
    }
  ],
  "title": "Profound thrombocytopenia and transient leucoerythroblastosis following hip fracture surgery",
  "title_text": "Profound thrombocytopenia and transient leucoerythroblastosis following hip fracture surgery",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:06Z",
  "url": "https://research.draconitic.com/paper/0990cw2n6r7kd",
  "venue": "BMJ Case Reports",
  "versions": []
}