PMID- 19825921
OWN - NLM
STAT- MEDLINE
DCOM- 20110520
LR  - 20220321
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Linking)
VI  - 16
IP  - 6
DP  - 2010 Dec
TI  - Fondaparinux for the treatment of acute heparin-induced thrombocytopenia: a 
      single-center experience.
PG  - 663-7
LID - 10.1177/1076029609347900 [doi]
AB  - Heparin-induced thrombocytopenia (HIT) is a life-threatening immune response to 
      heparin that is associated with a high risk of thromboembolic complications. The 
      syndrome is caused by antibodies that are reactive against complexes of platelet 
      factor 4/heparin (PF4/H). For patients with HIT, the discontinuation of heparin 
      alone is not sufficient and the diagnosis necessitates the administration of an 
      alternative anticoagulant. Fondaparinux is a synthetic pentasaccharide that binds 
      to antithrombin and potentiates inhibition of factor Xa. Data have shown that 
      fondaparinux is structurally too short to induce an antibody response and could 
      be a useful agent to treat HIT. In our hospital, we retrospectively analyzed the 
      use of fondaparinux in the treatment of 24 patients with acute HIT during 
      unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) 
      administration and compared the results to a similar population of 20 patients 
      who were treated with lepirudin. The treated patients had a complete platelet 
      count recovery, and none experienced a new thromboembolic complication or major 
      bleeding. The development of limb gangrene (2 patients who received lepirudin and 
      1 who received fondaparinux) likely resulted from a delay in diagnosis and 
      treatment initiation. Our data suggest that fondaparinux may be considered a safe 
      and an effective alternative treatment in HIT complicated with or without 
      thrombosis.
FAU - Grouzi, Elisavet
AU  - Grouzi E
AD  - Transfusion Medicine Department, KAT General Hospital, Athens, Greece. 
      egrouzi@otenet.gr
FAU - Kyriakou, Elias
AU  - Kyriakou E
FAU - Panagou, Ioannis
AU  - Panagou I
FAU - Spiliotopoulou, Ioanna
AU  - Spiliotopoulou I
LA  - eng
PT  - Journal Article
DEP - 20091013
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Polysaccharides)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*adverse effects/*therapeutic use
MH  - Female
MH  - Fondaparinux
MH  - Heparin, Low-Molecular-Weight/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polysaccharides/*therapeutic use
MH  - Retrospective Studies
MH  - Thrombocytopenia/*chemically induced/diagnosis/*drug therapy
MH  - Young Adult
EDAT- 2009/10/15 06:00
MHDA- 2011/05/21 06:00
CRDT- 2009/10/15 06:00
PHST- 2009/10/15 06:00 [entrez]
PHST- 2009/10/15 06:00 [pubmed]
PHST- 2011/05/21 06:00 [medline]
AID - 1076029609347900 [pii]
AID - 10.1177/1076029609347900 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2010 Dec;16(6):663-7. doi: 10.1177/1076029609347900. 
      Epub 2009 Oct 13.