Thrombocytopenia associated with low-molecular-weight heparin

Lecompte, Thomas; Luo, Shao Kai; Stieltjes, N.; Lecrubier, C; Samama, M; Tardy, B.; Zéni, Fabrice; Reynaud, J.; Tardy‐Poncet, Brigitte; Comtet, C.; Bertrand, Jean Claude

doi:10.1016/0140-6736(91)92090-o

Cited by 48 publications

(14 citation statements)

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“…Based on prospecitive studies, the incidence of HAT is assumed to occur in 2% of pa tients receiving porcine heparin [1], HAT is not dependent on a single type of heparin and has also been reported following low-dose heparin administration [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Heparin-Associated Thrombocytopenia : No Association of Immune Response with HLA

Greinacher¹,

Mueller-Eckhardt²

1993

Vox Sanguinis

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Heparin-associated thrombocytopenia (HAT) is a severe adverse reaction of heparin therapy. Patients with the immunologic type of HAT are at risk of developing arterial and venous thromboembolic complications caused by an antibody which activates platelets in the presence of heparin. Yet, there are no means to identify patients at risk of developing HAT before heparin administration. We investigated the frequency of HLA class-I and class-II antigens in 47 patients with the immunologic type of HAT verified by a positive two-point heparin-induced platelet activation assay. Compared to a control group of 629 healthy individuals HLA antigens B8 and DR3 were less frequent, whereas DR4 and DR53 had a higher frequency. However, none of these antigens proved to be statistically significant. This is another example of an immunologically mediated disease showing no discernible association with the HLA system.

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Section: Introductionmentioning

confidence: 99%

Heparin-Associated Thrombocytopenia : No Association of Immune Response with HLA

Greinacher¹,

Mueller-Eckhardt²

1993

Vox Sanguinis

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“…Insbesondere unfraktionierte Heparine stellen ein hohes Risiko für die Entwicklung einer HIT II dar. Aber auch unter Verwendung niedermolekularer Heparine sind Fälle bekannt [15,29] Um eine HIT II nachzuweisen wird der 14 C-Serotonin-Assay empfohlen [3], der sehr aufwändig ist, mehrere Tage dauert und deshalb nur in speziellen Labors durchgeführt wird [23]. Zur Diagnosestellung kommen weiterhin der heparininduzierte Plättchen-Aktivierungs-Test (HI-PA-Test) mit guter Spezifität und der Heparin/PF4-Elisa-Test mit einer hohen Sensitivität und einer geringeren Spezifität in Betracht.…”

Section: Kasuistikunclassified

Sinusvenenthrombose

Merz

Fehr

2004

Anaesthesist

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In the past 10 years numerous reports of cases referring to complications and their outcome with heparin-induced thrombocytopenia type II (HIT II) have been published. Clinically these symptoms are manifested as a combination of arterial and venous thromboembolisms. Mostly affected are the vessels of the limbs, the abdomen, kidneys and coronary arteries. We present the most rare initial manifestations of cerebral symptoms with headache, nausea, change of character and generalised convulsion, which have found their origin in sinus vein thrombosis and the treatment with the heparinoid danaparoid.

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“…Die kritische Durchsicht der internationalen Literatur ergab aber nur 9 Publikationen mit insgesamt 10 Falldarstellungen, wo sich eine HIT Typ II nach niedermolekularer Heparingabe entwickelte [2,3,4,6,16,25,26,27,29]. Bei 4 weiteren Patienten erhielten diese sowohl UFH als auch NMH, sodass nicht sicher das niedermolekulare Heparin für die ausgewiesene HIT Typ II verantwortlich gemacht werden kann [7,20,23,24].…”

Section: Diskussionunclassified