A prospective analysis of heparin-platelet factor 4 antibodies in pregnant women treated with the low-molecular-weight heparin, dalteparin
Autor: | Beate Luxembourg, Edelgard Lindhoff-Last, Frank Gerdsen, Florian Länger, Rupert Bauersachs |
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Rok vydání: | 2008 |
Předmět: |
Adult
Dalteparin medicine.medical_specialty medicine.drug_class Low molecular weight heparin Platelet Factor 4 Autoantigens Fibrinolytic Agents Antibody Specificity Pregnancy Heparin-induced thrombocytopenia Internal medicine medicine Humans Multicenter Studies as Topic Thrombophilia Antigens Human Platelet Prospective Studies Seroconversion Autoantibodies Purpura Thrombocytopenic Idiopathic Dalteparin sodium Dose-Response Relationship Drug business.industry Heparin Platelet Count Anticoagulant Pregnancy Complications Hematologic Thrombosis Hematology General Medicine medicine.disease Surgery Female business Platelet factor 4 medicine.drug |
Zdroj: | Blood coagulationfibrinolysis : an international journal in haemostasis and thrombosis. 19(6) |
ISSN: | 0957-5235 2500-1000 |
Popis: | Indications for heparin during pregnancy are expanding. Heparin-induced thrombocytopenia caused by heparin-platelet factor 4 antibodies (HPF4-As), however, remains a serious concern. While up to 50% of cardiovascular surgical patients develop HPF4-As while receiving heparin, the rate of seroconversion is lower in medical patients, suggesting an impact of the patient population on the underlying immune response. We therefore prospectively analyzed HPF4-As development in 31 pregnant women (32±5 years) receiving thromboprophylaxis with dalteparin for more than 4 weeks. According to their individual risk, study individuals were stratified to receive subcutaneous dosages of 2500-10000IU/day. The median treatment duration was 33 weeks (6-45 weeks). HPF4-As isotypes (IgG, IgM, IgA) were measured at baseline, on days 6-9, days 19-21 and subsequently every month until the end of therapy. Platelet counts and clinical examinations were carried out routinely or earlier if indicated. Throughout the study no thromboembolic event occurred, and in none of the patients was HPF4-As seroconversion noted. A prolonged drop in platelets to less than 50% from baseline was observed in one case (3%) after 35 weeks of treatment, which spontaneously resolved after child delivery. These findings suggest that long-term thromboprophylaxis with low-molecular-weight heparin is associated with a low rate of HPF4-As seroconversion in pregnancy. Blood Coagul Fibrinolysis 19:477-481 © 2008 Wolters Kluwer Health Lippincott Williams & Wilkins. |
Databáze: | OpenAIRE |
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