Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases

Autor: M. Wolf, Ismail Elalamy, Brigitte Tardy-Poncet, P. Ffrench, Anne Bauters, Dominique Lasne, Bernard Tardy
Přispěvatelé: Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Institute of Neuropathology, University hospital of Zurich [Zurich], Centre de physique moléculaire optique et hertzienne (CPMOH), Centre National de la Recherche Scientifique (CNRS)-Université Sciences et Technologies - Bordeaux 1, Signalisation cellulaire, dynamique circulatoire et athérosclérose précoce (SCDCAP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2009
Předmět:
Male
MESH: Hemostasis
MESH: Heparin
MESH: Chondroitin Sulfates
Danaparoid
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Gastroenterology
MESH: Recombinant Proteins
MESH: Cross Reactions
0302 clinical medicine
Platelet
MESH: Aged
MESH: Middle Aged
Chondroitin Sulfates
MESH: Purpura
Thrombocytopenic
Idiopathic
MESH: Hirudins
Hirudins
Middle Aged
Thrombosis
Recombinant Proteins
3. Good health
Intensive Care Units
Female
medicine.drug
medicine.medical_specialty
Dermatan Sulfate
Cross Reactions
MESH: Anticoagulants
03 medical and health sciences
MESH: Heparitin Sulfate
Heparin-induced thrombocytopenia
Internal medicine
Intensive care
medicine
Humans
MESH: Dermatan Sulfate
Aged
Retrospective Studies
Hemostasis
Purpura
Thrombocytopenic
Idiopathic
MESH: Humans
Heparin
business.industry
Vascular disease
Anticoagulants
MESH: Retrospective Studies
030208 emergency & critical care medicine
medicine.disease
MESH: Male
Surgery
Embolism
[SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
MESH: Intensive Care Units
Heparitin Sulfate
Complication
business
MESH: Female
Zdroj: Intensive Care Med
Intensive Care Med, 2009, 35 (8), pp.1449-53. ⟨10.1007/s00134-009-1464-x⟩
ISSN: 1432-1238
0342-4642
DOI: 10.1007/s00134-009-1464-x
Popis: International audience; PURPOSE: Danaparoid is a safe and effective drug for the treatment of heparin-induced thrombocytopenia (HIT). We describe an uncommon complication: danaparoid cross-reactivity with HIT antibodies. DESIGN AND SETTING: A retrospective observational multicenter study on HIT was conducted in France. In this study concerning HIT patients treated with lepirudin, 12 patients were treated with lepirudin because danaparoid cross-reacted with the heparin-dependent antibodies. RESULTS: Three groups of situations can be separated. In a first group, four patients received a short course of danaparoid until their initial functional HIT assay showed a cross-reactivity between danaparoid and HIT antibodies. One patient presented a fatal thrombotic complication but the relationship between this thrombotic complication and danaparoid cross-reactivity cannot be certain. In a second group, four patients received for 4 days at least a danaparoid treatment while the initial functional test did not show any danaparoid cross-reactivity. During danaparoid treatment, no significant increase of platelet count was observed and two patients presented a fatal thrombotic complication. In a third group, cross-reactivity between danaparoid and HIT antibodies was not checked before danaparoid therapy. During danaparoid treatment, no significant increase of platelet count was observed and the four patients developed a venous thromboembolic complication. CONCLUSION: Absence of any increase in platelet count after 3 to 5 days of danaparoid therapy and/or the occurrence of a new thrombotic event should lead to danaparoid cross-reactivity suspicion. However, before attributing thrombotic complications to danaparoid cross-reactivity, it is crucial to verify that the patients received the recommended danaparoid dosage regimen.
Databáze: OpenAIRE
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