[Heparin-associated thrombocytopenia: successful therapy of patients after prospective selection of a compatible heparinoid with the heparin-induced platelet activation test].

Abstract

Diagnosis of HAT type II and treatment of thromboembolic complications in these patients are difficult. Recently we have developed the heparin-induced platelet activation (HIPA) assay which allows a rapid confirmation of the tentative diagnosis of HAT type II. In vitro studies with sera of 25 patients revealed cross-reactivity to the LMW heparins Fragmin, Fraxiparin and Clexane whereas a LMW heparinoid, Org 10172 (Orgaran), did not. In a prospective study this heparinoid was selected for 10 HAT patients, for whom further parenteral anticoagulation was required. In 7 of these patients who received LMW heparins prior to laboratory investigations low platelet counts persisted under treatment with LMW heparins and 2 patients developed additional thromboembolic complications. Upon treatment with Org 10172 platelet counts normalized in 9 patients, in 1 patient thrombocytopenia was unrelated to parenteral anticoagulation, in 1 patient platelet count normalized after discontinuation of Org 10172. We conclude that the HIPA assay allows the laboratory diagnosis of HAT type II and the selection of a compatible heparin or heparinoid for further parenteral anticoagulation.

• Authors: A Greinacher, I Michels, C Mueller-Eckhardt
• Journal: Beitrage zur Infusionstherapie = Contributions to infusion therapy (Beitr Infusionsther) Vol. 30 Pg. 408-12 ( 1992) ISSN: 1011-6974 [Print] Switzerland
• Vernacular Title: Heparin-assoziierte Thrombozytopenie (HAT): Erfolgreiche Therapie von Patienten nach prospektiver Auswahl eines kompatiblen Heparinoids mit dem Heparin-induzierten Plättchenaktivierungs-(HIPA)-Test.
• PMID: 1284747 (Publication Type: English Abstract, Journal Article)

Chemical References

• Heparin, Low-Molecular-Weight
• Heparinoids
• Serotonin
• Heparin

Topics

• Cross Reactions
• Heparin (administration & dosage, adverse effects, classification)
• Heparin, Low-Molecular-Weight (administration & dosage, adverse effects)
• Heparinoids (administration & dosage, classification)
• Humans
• Platelet Activation (drug effects)
• Platelet Aggregation (drug effects)
• Platelet Count (drug effects)
• Prospective Studies
• Serotonin (blood)
• Thrombocytopenia (chemically induced, drug therapy)