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- W2015404491 abstract "Pentosan is an oral glycosaminoglycan that is indicated for chronic interstitial cystitis. Physicians prescribing it may not realize that, as an analogue of heparin, it may cause the heparin induced thrombocytopenia thrombosis syndrome with catastrophic complications. CASE REPORT A 35-year-old woman with an &year history of low estrogen oral contraceptive use presented with symptoms suggestive of chronic interstitial cystitis. She was treated with 100 mg. pentosan 3 times daily. After 3 weeks pentosan was stopped by a urologist who questioned the diagnosis of interstitial cystitis. Two days later the patient was treated for severe headache, nausea and vomiting. Progressive symptoms led to hospital admission 10 days later. She was moderately lethargic and had severe headache, neck stiffness and lateral gaze nystagmus. Magnetic resonance imaging showed complete thrombosis of the superior sagittal sinus extending to the left transverse and sigmoid sinuses. Blood counts were normal with 282 x lo9 platelets per 1. Heparin induced antibodies were negative on platelet aggregation. Serotonin release assay for heparin antibodies was negative but enzyme-linked immunosorbent assay performed elsewhere showed modest titer antiheparin platelet factor 4 antibody. Extensive tests for the causes of hypercoagulability were normal, including antiphospholipid antibody, factor V Leiden, coagulation control protein and plasma homocysteine determinations. Aspirin, dipyridamole and slow anticoagulation with warfarin were instituted, and symptoms improved. Ten months later the patient had a 4-hour episode of hemibody paresthesias that was considered to be transient and ischemic. One year after the initial episode of thrombosis she is asymptomatic except for infrequent headaches. Magnetic resonance imaging shows an unchanged clot. DISCUSSION" @default.
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- W2015404491 date "1998-12-01" @default.
- W2015404491 modified "2023-09-26" @default.
- W2015404491 title "PENTOSAN INDUCED CEREBRAL SAGITTAL SINUS THROMBOSIS: A VARIANT OF HEPARIN INDUCED THROMBOCYTOPENIA" @default.
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- W2015404491 doi "https://doi.org/10.1016/s0022-5347(01)62266-3" @default.
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