Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 2 ( 2018 ) > List of Articles


The Fondaparinux Paradox: Fondaparinux-Related Heparin-Induced Thrombocytopenia

Vishal Peshattiwar

Keywords : Fondaparinux, heparin-induced thrombocytopenia, thromboprophylaxis treatment

Citation Information : Peshattiwar V. The Fondaparinux Paradox: Fondaparinux-Related Heparin-Induced Thrombocytopenia. Indian J Crit Care Med 2018; 22 (2):116-118.

DOI: 10.4103/ijccm.IJCCM_189_17

License: CC BY-ND 3.0

Published Online: 01-02-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Fondaparinux, a pentasaccharide administered for heparin-induced thrombocytopenia (HIT), can lead to the occurrence of thrombocytopenia. This patient underwent aortic stent graft placement for Salmonella paratyphi A-infected abdominal aortic aneurysm. Fondaparinux was administered for anticoagulation that led to a dramatic decline in his platelet counts. Investigations revealed HIT profile, PF4/heparin by particle gel immunoassay to be positive. Fondaparinux, a prescribed anticoagulant for HIT can paradoxically predispose to thrombocytopenia.

PDF Share
  1. Lobo B, Finch C, Howard A, Minhas S. Fondaparinux for the treatment of patients with acute heparin-induced thrombocytopenia. Thromb Haemost 2008;99:208-14.
  2. Warkentin TE, Cook RJ, Marder VJ, Sheppard JA, Moore JC, Eriksson BI, et al. Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin. Blood 2005;106:3791-6.
  3. Warkentin TE, Maurer BT, Aster RH. Heparin-induced thrombocytopenia associated with fondaparinux. N Engl J Med 2007;356:2653-5.
  4. Pistulli R, Oberle V, Figulla HR, Yilmaz A, Pfeifer R. Fondaparinux cross-reacts with heparin antibodies in vitro in a patient with fondaparinux-related thrombocytopenia. Blood Coagul Fibrinolysis 2011;22:76-8.
  5. Bhatt VR, Aryal MR, Shrestha R, Armitage JO. Fondaparinux-associated heparin-induced thrombocytopenia. Eur J Haematol 2013;91:437-41.
  6. Linkins LA, Bates SM, Lee AY, Heddle NM, Wang G, Warkentin TE, et al. Combination of 4Ts score and PF4/H-paGIA for diagnosis and management of heparin-induced thrombocytopenia: Prospective cohort study. Blood 2015;126:597-603.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.