Heparin-induced thrombocytopenia and fatal thrombosis in a patient with activated protein C resistance

We report a 20-year-old woman who developed heparin-induced thrombocytopenia (HIT) associated with devastating and fatal multiorgan thrombosis. The patient, her mother, and her brother were found to have resistance to activated protein C (APC), and the congenital thrombophilia in this family was verified by the finding of the Arg 506 Gln mutation in factor V. This is the first case of HIT and APC resistance. The consequences of this association are discussed.