| Autor: |
Giles FJ; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Kanemaki TJ; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Otsuki JT; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Hamburg SI; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Yamashita JT; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Koh HA; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Fuerst MM; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Kusuanco DA; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Franco MM; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA., Lim SW; a Division of Hematology/Oncology, Department of Medicine , Cedars-Sinai Medical Center, UCLA School of Medicine , Los Angeles , California , USA. |
| Abstrakt: |
Skin necrosis is a rare complication of heparin therapy. Strong evidence suggests an immune-mediated mechanism in which heparin-antibody complexes bind to platelets, resulting in platelet aggregation, thromboembolism, and ischemic necrosis. Heparin-induced thrombocytopenia (HIT) may also occur in response to immune-mediated platelet aggregation. The presence, of heparin-dependent antibodies can be confirmed by platelet aggregometry, (14)C-serotonin release assay (SRA), or enzyme-linked immunosorbent assay (ELISA). Clinical suspicion, early detection and immediate cessation of heparin therapy are important in preventing the potentially severe complications of heparin-induced platelet aggregation. Potential therapeutic approaches include plasmapheresis and alternative forms of anticoagulation such as warfarin, aspirin, dipyridamole, or other novel investigational agents. |
