Heparin‐induced thrombocytopenia: Association with a platelet aggregating factor and arterial thromboses

American Journal of Hematology - Tập 6 Số 2 - Trang 125-133 - 1979
Philip L. Cimo1, Joel L. Moake2, Ronald S. Weinger2, Yoram Ben‐Menachem3, Kamal Khalil4
1Division of Hematology, The University of Texas Medical, School at Houston, Houston, TX 77030
2Department of Medicine, The University of Texas Medical School, Houston
3Department of Radiology, The University of Texas Medical School, Houston
4Thoracic and Cardiovascular Surgery, The University of Texas Medical School, Houston

Tóm tắt

AbstractEleven patients with heparin‐induced thrombocytopenia were studied. Thrombocytopenia appeared 3–16 days following the initiation of prophylactic or therapeutic doses of heparin. The mean lowest platelet count recorded was 48,000/mm3. When heparin was stopped, recovery from thrombocytopenia began within 24 hours and was complete by ten days. Two patients developed fatal thromboses, and two others had myocardial infarctions while thrombocytopenic. In the serum of seven patients, including three of the four with arterial thrombosis, a heparin‐dependent platelet aggregating factor was present. The factor caused release of platelet 14C serotonin but did not lyse platelets. It was present in the globulin fraction of all positive sera, and in one serum studied it was isolated in the IgG/IgA immunoglobulin fraction. The factor was not present in 16 normal sera or in the sera of 15 nonthrombocytopenic patients receiving heparin. Our observations suggest that heparin‐induced thrombocytopenia is common and that, in some patients it may be accompanied by severe arterial thrombosis. In vivo platelet aggregation is a possible explanation for the thrombocytopenia and the thrombosis in this disorder.

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Tài liệu tham khảo

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American Journal of Hematology

Tập 6 Số 2

125-133

Thông tin tác giả