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Huynh-Moynot S.,Federation dAnesthesie reanimation et des Urgences | Eyrieux S.,Federation dAnesthesie reanimation et des Urgences | Moynot J.-C.,Federation de Chirurgie | Commandeur D.,Federation dAnesthesie reanimation et des Urgences | And 3 more authors.
Annales de Biologie Clinique | Year: 2013

We report a case of a 47 years old woman. In her case of medical history, there were vein thrombosis and an allergic to tinzaparin. The patient entered in critical care unit under medical supervision for a multivisceral infarction due to an arterial mesenteric, renal and splenic thrombosis. An heparinotherapy was introduced. A laparotomy was realized because of an occlusion. Small intestine necrozed was removed. 8 days after the introduction of the heparin, there was a thrombocytopenia. Considering the background and the initiale situation, an heparin-induced thrombocytopenia of type II (HTI)was suspected. Whereas the heparinotherapy was stopped, the thrombocytopenia maked worse. Biological tests infirmed HIT's diagnosis.Arecurrent anemia in spite transfusions associated to a renal failure suggest a thrombotic microangiopathy whichwas secondary confirmed. The intensivist is sensibilized to evoke an heparin induced thrombocytopenia when there is a thrombocytopenia under heparin. However, he must not forget diagnosis of thrombocytopenia which required specific investigations and emergency treatment such as thrombotic microangiopathy.

PubMed | Federation danesthesie reanimation et des urgences.
Type: Case Reports | Journal: Annales de biologie clinique | Year: 2011

Sickle cell disease is the genetic disease most frequently detected at birth in France. The comprehension and knowledge of its pathophysiology allow to establish the principles of management for the drepanocytic patient, especially in the perioperative phase. In the light of recent recommendations published for anesthesia of a drepanocytic adult, this clinical case revealed allows to reexamine that subject, with a focus on biological aspects, which are transfusional strategy and antibioprophylaxy. The presented observation is a concrete feature of daily collaboration between clinician and biologist, which is an essential point of the ISO standard EN 15189 concerning laboratories accreditation.

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