Heparin-associated thrombocytopenia with venous thrombosis. A case report.

Mandt, P R; Robinson, Christy; Sarnoff, R B; Colwell, C W

doi:10.2106/00004623-198567070-00019

Cited by 4 publications

(3 citation statements)

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“…This type II HIT, which is triggered by the binding of antibodies to a platelet-heparin complex, leading to platelet activation and aggregation (7), is often associated to severe venous or arterial thrombosis (10,11). This life-threatening complication requires the immediate withdrawal of heparin and the use of antithrombotic drugs (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Antibodies to Macromolecular Platelet Factor 4-Heparin Complexes in Heparin-induced Thrombocytopenia: a Study of 44 Cases

Amiral¹,

et al. 1995

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SummaryAs heparin-PF4 (H-PF4) complexes are the target for antibodies associated to heparin-induced thrombocytopenia (HIT), an ELISA has been developed and optimised for testing antibodies binding to H-PF4. This test was consistently negative in 50 healthy subjects (A492 <0.3) and 35 patients with other causes of thrombocytopenia (A492 <0.5). In contrast, 43 out of 44 HIT patients showed antibodies to H-PF4 (A492 = 1.70 ± 0.81) including 5 patients with a negative platelet aggregation test. In one patient with HIT, antibodies to H-PF4 were already present at day 7, whereas platelet counts dropped ≤ 100 × 109/l only at days 11–12. Surprisingly, among 41 patients under heparin for >7 days, 5 showed antibodies to H-PF4, without HIT. These findings underline the major interest of this ELISA for the early diagnosis of HIT. We also showed that LMWH as well as other sulphated polysaccharides can bind to HIT antibodies in the presence of PF4 and that their reactivity is dependent on the molecular weight and the sulphation grade. The mechanism for HIT involves platelet PF4 receptors which bind the macromolecular H-PF4 complexes formed in the presence of a well defined heparin/PF4 ratio.

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Section: Introductionmentioning

confidence: 99%

Antibodies to Macromolecular Platelet Factor 4-Heparin Complexes in Heparin-induced Thrombocytopenia: a Study of 44 Cases

Amiral¹,

et al. 1995

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“…A meta-analysis of these scattered orthopaedic publications identified an estimated 22% amputation rate, 11% mortality rate, and 33% major complication rate with HIT. 6,7,9,17,42,47,56,64,65,68,70,74a,75,76,93,94 Although there are no known published reports of immune-mediated HIT in an orthopedic patient after a singular exposure to heparin or its derivatives, this author has observed a patient die of systemic complications related to HIT approximately one month after a single perioperative injection with a LMWH as prophylaxsis for a foot and ankle procedure. 50,67,106,109…”

Section: Background and Incidencementioning

confidence: 99%

Current Concepts Review: Heparin-Induced Thrombocytopenia

DiGiovanni

2008

Foot Ankle Int.

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“…Patients with preexisting stroke may be at greater risk of recurrent stroke due to HITP, even without significant thrombocytopenia, than patients with TIA or RIND. Neurologists should become familiar with the features of HITP and TE to avoid categorizing recur-*References 25,62,68,78,79,103,104,108,129,137,159. tReferences 5, 6, 9, 10, 47, 51, 54, 63, 65, 73, 102, 121, 155. rent stroke due to HITP as a simple failure of anticoagulation.…”

Section: Antiplatelet Agentsmentioning

confidence: 99%

Heparin-induced thrombocytopenia.

Becker

Miller

1989

Stroke

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There are two types of heparin-induced thrombocytopenia. Type I is more common, has an early onset, and is mild, transient, and benign. Type I is due to direct heparin-induced platelet aggregation and is rarely associated with thromboembolic sequela. Type II is infrequent, has a late onset, and is more severe. Type II is due to an immune-mediated platelet aggregation caused by IgG and IgM that becomes bound to platelets. In Type II, the antibody titers decline over several months; however, early reexposure can result in a catastrophic secondary immune response. Frequently, Type II is associated with life-or limb-threatening thromboembolic complications (white clots), including stroke. {Stroke 1989;20:1449-1459)

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Heparin-associated thrombocytopenia with venous thrombosis. A case report.

Cited by 4 publications

References 0 publications

Antibodies to Macromolecular Platelet Factor 4-Heparin Complexes in Heparin-induced Thrombocytopenia: a Study of 44 Cases

Antibodies to Macromolecular Platelet Factor 4-Heparin Complexes in Heparin-induced Thrombocytopenia: a Study of 44 Cases

Current Concepts Review: Heparin-Induced Thrombocytopenia

Heparin-induced thrombocytopenia.

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