{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:01:04Z","timestamp":1750204864910,"version":"3.40.5"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report a case of a 56\u2010year\u2010old woman with a history of idiopathic thrombocytopenic purpura (ITP) following splenectomy on mycophenolate mofetil (MMF), who developed moderate bleeding after stopping MMF. Her laboratory testing suggested the presence of an abnormal circulating heparin\u2010like anticoagulant with demonstrable anti\u2010Xa activity. She was initially treated with antifibrinolytic therapy and was subsequently started on MMF alongside intravenous immunoglobulin, which significantly improved her bleeding symptoms. The presence of abnormal circulating heparin\u2010like anticoagulants is a rare cause of coagulopathy. Few cases exist in the literature, with nearly all occurring in the setting of hematologic or solid\u2010organ malignancy. The mechanism by which these endogenous anticoagulants develop is unclear. Clinical manifestations range from mild bleeding and bruising to life\u2010threatening hemorrhage refractory to conventional therapy. Diagnosis of a heparin\u2010like anticoagulant is based on coagulation testing as well as exclusion of other exogenous anticoagulants, acquired inhibitors, and\/or factor deficiencies.<\/jats:p>","DOI":"10.1111\/trf.16236","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T23:53:02Z","timestamp":1608681182000},"page":"968-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Circulating heparin\u2010like anticoagulants: Case report and review of literature"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0991-5760","authenticated-orcid":false,"given":"Chenchen","family":"Hou","sequence":"first","affiliation":[{"name":"Division of Hematology and Thromboembolism, Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen A.","family":"Moffat","sequence":"additional","affiliation":[{"name":"Division of Hematology and Thromboembolism, Department of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Hamilton Regional Laboratory Medicine Program  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azim S.","family":"Gangji","sequence":"additional","affiliation":[{"name":"Division of Nephrology McMaster University and St. Joseph's Healthcare  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7675-4058","authenticated-orcid":false,"given":"Shuoyan","family":"Ning","sequence":"additional","affiliation":[{"name":"Division of Hematology St. Joseph's Healthcare Hamilton  Hamilton Ontario 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