A prospective study of the prevalence of heparin-induced antibodies and other associated thromboembolic risk factors in pediatric patients undergoing hemodialysis
| Autor: | Imen Kraiem, Henda El Euch, Saoussen Abroug, Abdelaziz Harbi, Hadef Skouri, Jalel Gargouri, Raoudha Gandouz |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Platelet Aggregation medicine.drug_class medicine.medical_treatment Gastroenterology Renal Dialysis Risk Factors Heparin-induced thrombocytopenia Internal medicine Thromboembolism medicine Prevalence Humans Platelet activation Prospective Studies Child Blood Coagulation Autoantibodies Lupus anticoagulant business.industry Heparin Anticoagulant Infant Hematology medicine.disease Thrombosis Blood Coagulation Factors Surgery Child Preschool Female Kidney Diseases Hemodialysis business Platelet factor 4 medicine.drug |
| Zdroj: | American journal of hematology. 81(5) |
| ISSN: | 0361-8609 |
| Popis: | Heparin, which is used at high doses in hemodialysis patients, may induce antibodies favoring thromboembolic complications. We prospectively investigated the prevalence of heparin-induced platelet-reactive antibodies in a cohort of 38 pediatric hemodialysis patients, by means of heparin/platelet factor 4 (H/PF4) ELISA and heparin-induced platelet activation assay (HIPA). We also assessed other acquired and congenital hypercoagulable states. Heparin-induced antibodies were detected in 13 and 21% of patients with HIPA and ELISA, respectively. Anti-H/PF4 antibodies were negatively correlated with the number of hemodialysis sessions. These antibodies disappeared after a median time of 6 months despite continuing heparin treatment. The prevalence of antiphospholipid antibodies was 21% (anticardiolipin 10.5%, anti-beta2GPI 13%, and lupus anticoagulant 5%). Blood levels of homocysteine, factor VIII, and fibrinogen were significantly higher and factor II levels were significantly lower in hemodialysis patients than in controls, whereas factor VII, factor IX, and natural coagulation inhibitor levels were similar in patients and controls. Overall, 26 of 38 patients had at least one biomarker of hypercoagulability, but only 1 patient, without anti-H/PF4 antibodies, presented with thrombosis. In conclusion, heparin induces the transient production of anti-H/PF4 antibodies in children undergoing hemodialysis, but other abnormalities probably contribute to hypercoagulability. These findings may help to improve the diagnosis and management of thrombotic events in hemodialysis patients. |
| Databáze: | OpenAIRE |
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