Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report
Anaphylaxis can induce life-threatening coagulopathy by releasing various mediators from activated mast cells. These mediators directly affect coagulation and fibrinolytic pathways, increasing the bleeding risk. Diagnosis and management of anaphylaxis-induced coagulopathy remain challenging. We repo...
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Elsevier
2025-01-01
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| Series: | Clinical Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1470211824054526 |
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| author | Rajkumar Rajendram Abdul Hadi Al-Qahtani Farrukh Sheikh |
| author_facet | Rajkumar Rajendram Abdul Hadi Al-Qahtani Farrukh Sheikh |
| author_sort | Rajkumar Rajendram |
| collection | DOAJ |
| description | Anaphylaxis can induce life-threatening coagulopathy by releasing various mediators from activated mast cells. These mediators directly affect coagulation and fibrinolytic pathways, increasing the bleeding risk. Diagnosis and management of anaphylaxis-induced coagulopathy remain challenging. We report a unique case of a 44-year-old man with undiagnosed systemic mastocytosis who developed peanut-induced anaphylactic shock, resulting in cardiac arrest. Laboratory tests revealed elevated serum tryptase and severe coagulopathy. Thromboelastography, a point-of-care viscoelastic monitoring (VEM) test identified the presence of heparin-like anticoagulants within minutes. Bone marrow examination subsequently confirmed isolated mastocytosis. This case highlights the potential of VEM for rapid diagnosis and management of coagulopathy in patients with anaphylaxis, potentially aiding in the identification of mast cell degranulation in undifferentiated shock. We suggest that VEM should be considered in the investigation of patients with suspected anaphylaxis-induced coagulopathy. |
| format | Article |
| id | doaj-art-e983e46d2d3846a9aa494a388f12d2dc |
| institution | Kabale University |
| issn | 1470-2118 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Medicine |
| spelling | doaj-art-e983e46d2d3846a9aa494a388f12d2dc2025-02-06T05:11:14ZengElsevierClinical Medicine1470-21182025-01-01251100267Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case reportRajkumar Rajendram0Abdul Hadi Al-Qahtani1Farrukh Sheikh2Department of Acute General Medicine, John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom; Medical Protocol Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Corresponding author.Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Department of Medicine King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; Department of Medicine King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaAnaphylaxis can induce life-threatening coagulopathy by releasing various mediators from activated mast cells. These mediators directly affect coagulation and fibrinolytic pathways, increasing the bleeding risk. Diagnosis and management of anaphylaxis-induced coagulopathy remain challenging. We report a unique case of a 44-year-old man with undiagnosed systemic mastocytosis who developed peanut-induced anaphylactic shock, resulting in cardiac arrest. Laboratory tests revealed elevated serum tryptase and severe coagulopathy. Thromboelastography, a point-of-care viscoelastic monitoring (VEM) test identified the presence of heparin-like anticoagulants within minutes. Bone marrow examination subsequently confirmed isolated mastocytosis. This case highlights the potential of VEM for rapid diagnosis and management of coagulopathy in patients with anaphylaxis, potentially aiding in the identification of mast cell degranulation in undifferentiated shock. We suggest that VEM should be considered in the investigation of patients with suspected anaphylaxis-induced coagulopathy.http://www.sciencedirect.com/science/article/pii/S1470211824054526Case reportAnaphylaxisHeparinHeparin-like mediatorCoagulopathySystemic mastocytosis |
| spellingShingle | Rajkumar Rajendram Abdul Hadi Al-Qahtani Farrukh Sheikh Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report Clinical Medicine Case report Anaphylaxis Heparin Heparin-like mediator Coagulopathy Systemic mastocytosis |
| title | Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report |
| title_full | Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report |
| title_fullStr | Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report |
| title_full_unstemmed | Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report |
| title_short | Thromboelastography for rapid diagnosis of heparin-like anticoagulant release during anaphylaxis-induced coagulopathy in systemic mastocytosis: a case report |
| title_sort | thromboelastography for rapid diagnosis of heparin like anticoagulant release during anaphylaxis induced coagulopathy in systemic mastocytosis a case report |
| topic | Case report Anaphylaxis Heparin Heparin-like mediator Coagulopathy Systemic mastocytosis |
| url | http://www.sciencedirect.com/science/article/pii/S1470211824054526 |
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