{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:27:41Z","timestamp":1789122461126,"version":"build-2803163510"},"reference-count":20,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,7]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>We describe the case of a 65-year-old male who presented to an outside hospital for shortness of breath, nausea and vomiting 8 days after testing positive for COVID-19. Initial workup revealed massive bilateral pulmonary emboli and thrombocytopenia. The patient was then admitted to our hospital, received an inferior vena cava filter and initially started on argatroban for autoimmune heparin-induced thrombocytopenia (HIT) prophylaxis. On hospital stay day 6, labs revealed a diagnosis of HIT in the setting of COVID-19. This case highlights the rare occurrence of a patient developing HIT without heparin exposure and in the setting of a novel infectious agent, COVID-19.<\/jats:p>","DOI":"10.1136\/bcr-2021-243315","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T11:56:45Z","timestamp":1621857405000},"page":"e243315","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Autoimmune heparin-induced thrombocytopenia: a rare manifestation of COVID-19"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3427-9997","authenticated-orcid":false,"given":"Katherine","family":"Julian","sequence":"first","affiliation":[{"name":"Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Bucher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"2025082709454428000_14.5.e243315.1","unstructured":"CDC . COVID data Tracker. (n.d.), 2021. Available: https:\/\/covid.cdc.gov\/covid-data-tracker\/#datatracker-home"},{"key":"2025082709454428000_14.5.e243315.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2020.03.022"},{"key":"2025082709454428000_14.5.e243315.3","doi-asserted-by":"crossref","DOI":"10.4081\/hr.2021.8857","article-title":"Heparin-Induced thrombocytopenia and COVID-19","volume":"13","author":"Sartori","year":"2021","journal-title":"Hematol Rep"},{"key":"2025082709454428000_14.5.e243315.4","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2013.1.668"},{"key":"2025082709454428000_14.5.e243315.5","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2007.059188"},{"key":"2025082709454428000_14.5.e243315.6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2109"},{"key":"2025082709454428000_14.5.e243315.7","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13813"},{"key":"2025082709454428000_14.5.e243315.8","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1080\/17474086.2019.1636645","article-title":"High-Dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review","volume":"12","author":"Warkentin","year":"2019","journal-title":"Expert Rev Hematol"},{"key":"2025082709454428000_14.5.e243315.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.073"},{"key":"2025082709454428000_14.5.e243315.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2006.05.001"},{"key":"2025082709454428000_14.5.e243315.11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1182\/asheducation-2009.1.153","article-title":"Drug-Induced thrombocytopenia: pathogenesis, evaluation, and management","author":"George","year":"2009","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"2025082709454428000_14.5.e243315.12","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s10557-020-07066-x","article-title":"Thrombin inhibition by argatroban: potential therapeutic benefits in COVID-19","volume":"35","author":"Aliter","year":"2021","journal-title":"Cardiovasc Drugs Ther"},{"key":"2025082709454428000_14.5.e243315.13","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/1060028020943542","article-title":"Intravenous immune globulin (IVIg) for treatment of autoimmune heparin-induced thrombocytopenia: a systematic review","volume":"55","author":"Dougherty","year":"2021","journal-title":"Ann Pharmacother"},{"key":"2025082709454428000_14.5.e243315.14","unstructured":"NIH . Antithrombotic therapy in patients with COVID-19, 2021. Available: https:\/\/www.covid19treatmentguidelines.nih.gov\/antithrombotic-therapy\/"},{"key":"2025082709454428000_14.5.e243315.15","doi-asserted-by":"publisher","DOI":"10.2450\/2020.0083-20"},{"key":"2025082709454428000_14.5.e243315.16","doi-asserted-by":"crossref","DOI":"10.1002\/ajh.25935","article-title":"Heparin induced thrombocytopenia antibodies in Covid-19","author":"Patell","year":"2020","journal-title":"Am J Hematol"},{"key":"2025082709454428000_14.5.e243315.17","first-page":"13","article-title":"Is there an association between heparin-induced thrombocytopenia (HIT) and autoimmune disease?","volume":"117","author":"Klinkhammer","year":"2018","journal-title":"WMJ"},{"key":"2025082709454428000_14.5.e243315.18","unstructured":"Expert Hematology Panel . Guidance produced from the expert haematology panel (Ehp) focussed on syndrome of thrombosis and thrombocytopenia occurring after coronavirus vaccination, 2021."},{"key":"2025082709454428000_14.5.e243315.19","article-title":"Cerebral venous sinus thrombosis and thrombocytopenia after COVID-19 vaccination - A report of two UK cases","author":"Mehta","year":"2021","journal-title":"Brain Behav Immun"},{"key":"2025082709454428000_14.5.e243315.20","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa2105385","article-title":"Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination","author":"Scully","year":"2021","journal-title":"N Engl J Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:45:56Z","timestamp":1756313156000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,24]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2021-243315"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243315","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}