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Anti Factor Xa Assay for Effective Monitoring of Heparin: A Case Report

Category: CASE_STUDY
Authors: Paluri R, Darapu H, Koya S, Marques S
Abstract:Unfractionated Heparin (UFH) is a widely used anticoagulant for inpatient setting. This is routinely monitored by activated partial thromboplastin time (APTT) in several laboratories. However, this method has been associated with high degree of variability influenced by several factors. Very few cases of sub-therapeutic heparin in spite of appropriate APTT were reported. Here we describe a clinical case of deep venous thrombosis who was initially treated with heparin drip adjusted to therapeutic APTT, that eventually progressed to extensive thrombosis. Due to history of lupus, baseline elevation of APTT and possible sub-therapeutic dosage was suspected. Further investigation by checking anti-Xa levels revealed that patient had been sub therapeutically dosed with UFH, suggesting that APTT is not a reliable estimate for heparin monitoring. KEYWORDS: Heparin monitoring; Lupus; anti factor Xa, APTT
Year: 2014
Month: October
Volume: 3
Issue: 4
Published on: 14-10-2014