Abstract |
Heparin-induced thrombocytopenia (HIT) is a transient antibody-mediated hypercoagulability state strongly associated with lower-limb deep-vein thrombosis (DVT). Whether HIT is additionally associated with upper-limb DVT--either with or without central venous catheter (CVC) use--is unknown. We therefore studied 260 patients with antibody-positive HIT to determine the influence of CVC use on frequency and localization of upper-extremity DVT in comparison with 2 non-HIT control populations (postoperative orthopedic surgery and intensive-care unit patients). Compared with the control populations, both upper- and lower-extremity DVTs were found to be associated with HIT. Upper-extremity DVTs occurred more frequently in HIT patients with a CVC (14 of 145 [9.7%]) versus none of 115 (0%) patients without a CVC (P =.000 35). All upper-extremity DVTs occurred at the CVC site (right, 12; left, 2; kappa = 1.0; P =.011). We conclude that a localizing vascular injury (CVC use) and a systemic hypercoagulability disorder (HIT) interact to explain upper-extremity DVT complicating HIT.
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Authors | Aaron P Hong, Deborah J Cook, Christopher S Sigouin, Theodore E Warkentin |
Journal | Blood
(Blood)
Vol. 101
Issue 8
Pg. 3049-51
(Apr 15 2003)
ISSN: 0006-4971 [Print] United States |
PMID | 12506031
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
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Topics |
- Arm
(blood supply)
- Autoimmune Diseases
(chemically induced, complications)
- Case-Control Studies
- Catheterization, Central Venous
(adverse effects)
- Heparin
(adverse effects, immunology)
- Humans
- Ontario
(epidemiology)
- Postoperative Complications
(etiology)
- Retrospective Studies
- Risk
- Thrombocytopenia
(chemically induced, complications)
- Venous Thrombosis
(epidemiology, etiology)
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