PMID- 12780795
OWN - NLM
STAT- MEDLINE
DCOM- 20031007
LR  - 20190705
IS  - 0007-1048 (Print)
IS  - 0007-1048 (Linking)
VI  - 121
IP  - 5
DP  - 2003 Jun
TI  - Biological and clinical features of low-molecular-weight heparin-induced 
      thrombocytopenia.
PG  - 786-92
AB  - Heparin-induced thrombocytopenia (HIT) is a common adverse effect of 
      unfractionated heparin (UFH) therapy. In contrast, only a few patients have been 
      reported with HIT following low-molecular-weight heparin (LMWH) therapy 
      (LMW-HIT). To define the clinical and biological characteristics of LMW-HIT, 180 
      patients treated for suspected HIT at 15 French centres were investigated. 
      Clinical history was recorded and HIT was confirmed in 59 patients with positive 
      serotonin release assay results: 57 of them had high levels of antibodies (Abs) 
      to heparin-platelet factor 4 complexes (H/PF4) and two had Abs to interleukin 8. 
      Eleven patients were treated exclusively with LMWH (LMW-HIT) and 48 with UFH 
      either alone (UF-HIT, n = 34) or combined with LMWH (UF/LMW-HIT, n = 14). The 
      LMW-HIT and UF-HIT groups were similar with respect to sex, age, platelet count 
      before heparin therapy, frequency of bleeding and occurrence of disseminated 
      intravascular coagulation. The interval to onset of HIT was longer in LMW-HIT 
      patients compared with UF-HIT patients (P = 0.03). Severe thrombocytopenia 
      (platelets < 15 x 10(9)/l) was more frequent in the LMW-HIT group (P = 0.04). 
      Thrombosis occurred in three of 11 LMW-HIT patients, i.e. as frequently as in 
      UF-HIT patients. LMW-HIT is potentially severe and may be observed after longer 
      heparin treatment compared with UF-HIT. It is highly recommended, therefore, that 
      platelet counts be monitored carefully whenever LMWH is administered.
FAU - Gruel, Yves
AU  - Gruel Y
AD  - Tours Laboratoire d'hematologie hemostase, France. gruel@med.univ-tours.fr
FAU - Pouplard, Claire
AU  - Pouplard C
FAU - Nguyen, Philippe
AU  - Nguyen P
FAU - Borg, Jeanne-Yvonne
AU  - Borg JY
FAU - Derlon, Annie
AU  - Derlon A
FAU - Juhan-Vague, Irene
AU  - Juhan-Vague I
FAU - Regnault, Veronique
AU  - Regnault V
FAU - Samama, Michel
AU  - Samama M
CN  - French Heparin-Induced Thrombocytopenia Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (Antibodies)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 37270-94-3 (Platelet Factor 4)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies/blood
MH  - Anticoagulants/*adverse effects
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Heparin, Low-Molecular-Weight/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Count
MH  - Platelet Factor 4/immunology
MH  - Prospective Studies
MH  - Thrombocytopenia/*chemically induced
EDAT- 2003/06/05 05:00
MHDA- 2003/10/08 05:00
CRDT- 2003/06/05 05:00
PHST- 2003/06/05 05:00 [pubmed]
PHST- 2003/10/08 05:00 [medline]
PHST- 2003/06/05 05:00 [entrez]
AID - 4363 [pii]
AID - 10.1046/j.1365-2141.2003.04363.x [doi]
PST - ppublish
SO  - Br J Haematol. 2003 Jun;121(5):786-92. doi: 10.1046/j.1365-2141.2003.04363.x.