Heparin-Induced Thrombocytopaenia Complicated By Arterial and Venous Thrombosis: Report of 2 Cases Successfully Treated by Danaparoid Sodium

Darling, Katharine E A; Jaumotte, C; Saussoy, Pascale; Zech, Francis; Lavenne, E.; Hainaut, Philippe

doi:10.1080/17843286.2000.11754291

Cited by 3 publications

(1 citation statement)

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“…32 The use of danaparoid in patients with HIT has been associated with variable success. [33][34][35][36] In addition, danaparoid has a number of limitations that have hampered its use. The molecule has been reported to be cross-reactive with heparin antibodies in 10% to 40% of cases.…”

Section: Danaparoidmentioning

confidence: 99%

New Treatment Options for Heparin-Induced Thrombocytopenia

Young

2002

Journal of Pharmacy Practice

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Heparin, in various forms, is used in a variety of conditions including prophylaxis and treatment of thromboembolic disorders. Although the most common adverse effect related to the use of heparin is bleeding, heparin-induced thrombocytopenia (HIT) can also occur. Two types of HIT exist, HIT type I and type II. HIT type I is a mild and self-limiting disease in which the patient's platelet count may decrease slightly but will recover with continued treatment. This is in contrast to HIT type II, which may lead to potentially devastating complications. Patients with HIT type II are at increased risk for thromboembolic complications that are mediated through autoimmune reactions and therefore require anticoagulation with danaparoid or one of the direct thrombin inhibitors, including lepirudin, argatroban, or bivalirudin. Limited data are available on the use of these agents in special populations including patients who are pregnant or those undergoing procedures such as percutaneous coronary intervention, cardiopulmonary bypass and dialysis, and pregnancy. Future therapies may include the use of unfractionated heparin in combination with glycoprotein IIb/IIIa inhibitors during cardiopulmonary bypass.

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Section: Danaparoidmentioning

confidence: 99%

New Treatment Options for Heparin-Induced Thrombocytopenia

Young

2002

Journal of Pharmacy Practice

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Heparin-induced thrombocytopenia (HIT)

Magnani¹,

Gallus²

2006

Thromb Haemost

100

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Clinical outcomes of 1,478 danaparoid treatment case reports for HIT (involving 1,418 patients) treated between 1982 and mid-2004 are analysed. Treatment in 1,291 episodes was for current HIT. Thromboembolism due to HIT was present in 39.4%. The patients include 33 children and 32 pregnancies. Two hundred twenty-six patients required extra-corporeal circuit use for renal failure, 241 patients had a concomitant thrombophilic disorder, and 351 major operations were performed. Clinical outcomes were assessed during danaparoid treatment (range one day to 3.5 years) plus three months of follow-up. Of the danaparoid-treated patients 83.8% survived; 63.7% had no or minor adverse events and 20.1% suffered serious non-fatal adverse events. New thromboses occurred during 9.7% of treatment episodes, and 16.4% of treatment episodes had an inadequate treatment response (i. e. developed one or more of the following: new/extended thrombosis, persistent/new platelet count reduction, unplanned amputation during treatment and follow-up). Major bleeding was reported in 8.1% of treatment episodes. Clinical cross-reactivity of danaparoid (new/persistent platelet count reduction and/or new/extended thrombosis) was confirmed serologically in 23 of 36 patients with positive pretreatment serological danaparoid cross-reactivity and in 22 of 32 additional patients tested at the time of the new event, i.e. a total of 45 patients (3.2%). Clinical outcomes of these case reports of patients given danaparoid because of suspected or confirmed HIT appear to be comparable with those reported by others who used direct thrombin inhibitors, especially when a sufficient danaparoid dosing intensity was used in patients with isolated HIT. Post-operative bleeding limits danaparoid use for cardiopulmonary by-pass surgery. Routine clinical and platelet count monitoring are required to minimise adverse reactions due to cross-reactivity.

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Acute Adrenal Insufficiency Associated With Heparin-Induced Thrombocytopenia

Poulain

Lambert

Coche

et al. 2008

Acta Clinica Belgica

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Although the thrombotic risk of heparin-induced thrombocytopaenia (HIT) is well recognized and may affect any vascular bed, the involvement of adrenal veins has been less commonly described. We report the case of a 86-year-old woman who developed bilateral massive adrenal haematoma associated with HIT, resulting in acute adrenal insufficiency. After immediate discontinuation of heparin and starting therapy with danaparoid and hydrocortisone, the clinical evolution was favourable, although adrenal failure was irreversible. When abdominal pain, hypotension and fever occur during heparin therapy, associated with a drop in platelet count, acute adrenal insufficiency secondary to HIT should be considered, as early diagnosis is essential for the treatment of this life-threatening complication.

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Heparin-Induced Thrombocytopaenia Complicated By Arterial and Venous Thrombosis: Report of 2 Cases Successfully Treated by Danaparoid Sodium

Cited by 3 publications

References 0 publications

New Treatment Options for Heparin-Induced Thrombocytopenia

New Treatment Options for Heparin-Induced Thrombocytopenia

Heparin-induced thrombocytopenia (HIT)

Acute Adrenal Insufficiency Associated With Heparin-Induced Thrombocytopenia

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