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First published on December 26, 2007, doi:10.1177/1076029607309173

Clinical and Applied Thrombosis/Hemostasis 2008;14:360.

A more recent version of this article appeared on July 1, 2008
 © 2007 SAGE Publications

Article

Fatal Bleeding Due to a Heparin-Like Anticoagulant in a 37-Year-Old Woman Suffering From Systemic Mastocytosis

Christoph Sucker, MD, Georg Mansmann, MD, Stefan Steiner, MD, Norbert Gattermann, MD, PhD, Anette Schmitt-Graeff, MD, PhD, Robert Loncar, MD, Rudiger E. Scharf, MD, PhD, and Marcus Stockschlader, MD*

University of Freiburg, Germany

* To whom correspondence should be addressed. E-mail: stockschlaeder{at}med.uni-duesseldorf.de.


  Abstract
A 37-year-old female patient with systemic mastocytosis who was admitted with severe unexplained bleeding symptoms is studied. Laboratory procedures established the diagnosis of a patient-derived–heparin-like anticoagulant as a very rare hemostatic abnormality predisposing to bleeding. The patient died from refractory disease despite therapy with protamine, initiation of chemotherapy, and supportive measures. The case illustrates the clinical presentation and diagnosis of heparin-like anticoagulants. Etiology, pathophysiology, and therapeutic options are discussed.


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