Heparin-associated thrombocytopenia: Successful therapy with the heparinoid Org 10172 in a patient showing cross-reaction to LMW heparins
Autor: | Andreas Greinacher, H. J. Kohl, C. Mueller-Eckhardt, M. Gottsmann, W. Drost, M. Glaser, J. Leitl, I. Michels |
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Rok vydání: | 1992 |
Předmět: |
Male
medicine.medical_specialty medicine.drug_class medicine.medical_treatment Dermatan Sulfate Heparinoid Cross Reactions Pharmacology Fibrinolytic Agents In vivo Internal medicine medicine Humans Platelet Platelet activation Aged Glycosaminoglycans Chemotherapy Hematology Heparin business.industry Chondroitin Sulfates Anticoagulant food and beverages General Medicine Heparin Low-Molecular-Weight Thrombocytopenia Surgery Heparitin Sulfate business medicine.drug |
Zdroj: | Annals of Hematology. 64:40-42 |
ISSN: | 1432-0584 0939-5555 |
Popis: | A patient suffering from heparin-associated thrombocytopenia (HAT), recurrent arteriothromboses, and acute renal failure after treatment with standard heparin is described. He failed to improve when therapy was continued with low-molecular-weight (LMW) heparin (Fragmin, Kabi Pfrimmer, Erlangen, FRG). By means of the in vitro heparin-induced platelet activation (HIPA) assay it was shown that standard heparin and the LMW heparins Fragmin and Fraxiparin (Sanofi Labaz, Munich, FRG), as well as the enoxaparine Clexane (Nattermann, Cologne, FRG), all induced platelet activation with the patient's serum. In contrast, the LMW heparinoid Org 10172 (Organon, Oss, The Netherlands) did not cause platelet activation. When the patient was subsequently treated by parenteral administration of Org 10172 as anticoagulant over a period of several weeks the number of platelets rapidly increased and the patient almost completely recovered. This case shows that strong in vivo and in vitro cross-reactivity between standard heparin and LMW heparins may occur, but can be avoided by the use of a novel heparinoid, Org 10172. The HIPA assay provides a simple and sensitive laboratory method for the choice of an innocuous heparin or heparinoid for continued parenteral anticoagulation. |
Databáze: | OpenAIRE |
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