ArticleLaboratory medicine2025
Heparin resistance in a patient with severe acute pancreatitis: a case report.
Article in Laboratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSevere acute pancreatitis is a life-threatening condition characterized by systemic inflammatory response syndrome and an increased risk of complications such as venous thrombosis, all of which contributes to a high mortality rate. Heparin resistance, although rare, can lead to ineffective anticoagulation and thrombus formation during unfractionated heparin therapy, complicating management.
methodsWe report a case of heparin resistance in which, despite increasing the unfractionated heparin dosage, the patient's activated partial thromboplastin time remained subtherapeutic.
resultsLaboratory findings indicated normal antithrombin levels but undetectable anti-Xa activity, confirming non-antithrombin-mediated heparin resistance. A multidisciplinary approach led to the successful management of thrombosis with rivaroxaban, resulting in substantial clinical improvement. DISCUSSION: This case highlights the importance of early recognition and management of heparin resistance in patients with severe acute pancreatitis. Combined monitoring of activated partial thromboplastin time and anti-Xa activity is crucial for optimizing anticoagulation therapy and preventing complications such as deep vein thrombosis.
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