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Heparin resistance in a patient with severe acute pancreatitis: a case report

Year: 2025

Type: article

Abstract: INTRODUCTION: Severe 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. METHODS: We report a case of heparin resistance in which, despite increasing the unfractionated heparin dosage, the patient's activated partial thromboplastin time remained subtherapeutic. RESULTS: Laboratory 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.

Source: Laboratory Medicine

DOI: 10.1093/labmed/lmae126

Authors: Dai Rongqin, Bai Zhexin, Liu Yuzhi, Guo Zhenbin, Zhang Jinbiao

Institutions: Cangzhou Medical College, Capital Medical University, Beijing Chest Hospital, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province

Language: English

Topic: Blood Coagulation and Thrombosis Mechanisms

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,535