Venous thrombosis in the brain and upper limbs associated with thrombopenia induced by pentosan polysulfate

The authors report a new observation of thrombocytopenia thrombosis syndrome induced by a synthetic heparinoid: pentosan polysulfate and presenting with dural sinus thrombosis. This syndrome was aggravated by standard heparin therapy. Thrombocytopenia was due to an immunological mechanism and preceded thrombotic phenomena, so emphasizing the need for platelet counts in all patients considered for heparin or synthetic heparinoid therapy.