Two patients present with the same disease. A 60 year old man with three vessel coronary artery disease presents for a routine coronary artery bypass surgery. The surgery is uneventful until the team prepares to go onto bypass. Administration of a weight-based dose of heparin has very little effect on the patient's activated clotting time. His 25 year old daughter presents with her second episode of an unprovoked deep vein thrombosis.
Challenge: What's going on?
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3 comments:
Antithrombin III deficiency!
(Just learned this today)
Antithrombin III deficiency? resistant to usual dose of heparin cases.. but not sure if it is hereditary
super!! i haven't seen this one clinically, but i get asked about it over and over.
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Resistant
This is antithrombin III deficiency.
Source: UpToDate.
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