Extremely low doses of lepirudin in a patient with heparin‐induced thrombocytopenia, high bleeding risk and renal insufficiency

Development and implementation of a nurse-driven, sliding-scale nomogram for bivalirudin in the management of heparin-induced thrombocytopenia

“…8 Prior to that, lepirudin had fallen out of favor in many institutions due to its prolonged half-life and the risk of bleeding associated with its use, particularly in patients with renal dysfunction. [9][10][11][12][13][14] Some studies have demonstrated that critically ill patients are at increased risk for argatroban-induced bleeding relative to other patients and often require lower dosages than those cited in the product labeling. [15][16][17][18][19][20][21] Furthermore, argatroban dosing changes are commonly based on calculating percentage increases and decreases, which may lead to dosing errors and inconsistencies and is a time-consuming process.…”

Clinical characteristics and risk factors of intracranial hemorrhage in systemic lupus erythematosus

“…We analyzed and compared the following data: gender, age at SLE onset, age at admission to PUMCH, disease duration, serositis, nephropathy, hematological disturbance, nervous system disturbance (including all the neuropsychiatric syndromes defined by the 1999 ACR criteria for NPSLE), microscopic hematuria, albuminuria, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hypocomplimentemia, thrombocytopenia (classified as severe (platelet count: < 20 Â 10 9 /l), moderate (platelet count: 20-50 Â 10 9 /l), and mild (platelet count > 50 Â 10 9 /l and <100 Â 10 9 /l)), prolonged prothrombin time (PT, defined as 3 seconds (s) longer than the reference), lupus anticoagulant (LA), anti-nuclear antibody, anti-double-stranded DNA (anti-dsDNA) antibody, anti-ENA antibodies (including anti-SSA, anti-SSB, anti-Sm, anti-RNP, and anti-rRNP antibody), anti-cardiolipin (IgG-aCL) antibody, SLE disease activity index (SLEDAI, stratified to stable (<5), mild active (5)(6)(7)(8)(9), moderate active (10)(11)(12)(13)(14), and severe active (>14)), 17 antiphospholipid syndrome diagnosed according to revised classification criteria for antiphospholipid syndrome, 18 hypertension (defined as systolic blood pressure !140 mmHg and/or diastolic blood pressure !90 mmHg), diabetes (defined as fasting glucose level !126 mg per deciliter, twohour glucose level !200 mg per deciliter, or both), personal history of smoking (defined as having smoked at least 100 cigarettes), 19 and family history of cerebrovascular disease. Two or more occasions of IgG-aCL and LA, at least 12 weeks apart, were recorded.…”

“…However, intracranial hemorrhage in SLE patients is rarely reported, and most of the reports are of subarachnoid hemorrhage. [9][10][11][12][13][14][15] Therefore, in this study, we retrospectively analyzed medical data of 26 SLE patients with intracranial hemorrhages and 104 SLE patients without intracranial hemorrhage to explore the characteristics and risk factors for intracranial hemorrhage in SLE patients.…”