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Serological investigation of patients with a previous history of heparin-induced thrombocytopenia who are reexposed to heparin

, : Serological investigation of patients with a previous history of heparin-induced thrombocytopenia who are reexposed to heparin. Blood 123(16): 2485-2493

Heparin reexposure despite a history of previous heparin-induced thrombocytopenia (HIT) can be appropriate if platelet-activating antibodies are no longer detectable. We determined the frequency, timing, and magnitude of the antiplatelet factor 4 (anti-PF4)/heparin immune response (by serotonin-release assay [SRA] and enzyme-immunoassay [EIA]), and the frequency of recurrent HIT in 20 patients with previous HIT reexposed to heparin 4.4 years (mean) post-HIT; 17 patients were given heparin intraoperatively (without postoperative heparin) for cardiac/vascular surgery. One patient developed recurrent HIT beginning 7 days after cardiac surgery, with newly regenerated HIT antibodies exhibiting strong heparin-independent platelet-activating properties. Intraoperative heparin induced EIA seroconversion in 11/17 (65%) patients (immunoglobulin G [IgG]>IgA>IgM) and SRA seroconversion in 8/17 (47%), whereas none of 3 medical patients reexposed to heparin developed seroconversion. Anti-PF4/heparin IgG became detectable at day 7 (median), ie, no sooner than observed in typical-onset HIT. The high proportion of SRA positivity among EIA-seroconverting patients (8/11 [73%]) suggests that patients with previous HIT may be especially predisposed to forming recurrent antibodies with platelet-activating properties. We conclude that among patients with a previous history of HIT who are reexposed to intraoperative (but not postoperative) heparin, the risk of recurrent HIT appears to be low, but is possible if antibodies with strong heparin-independent platelet-activating properties are formed.


PMID: 24516044

DOI: 10.1182/blood-2013-10-533083

Other references

Sooknah, R., 2001: Performance of a laboratory-scale water hyacinth system in treating sugar factory wastewater. A study was conducted to determine the performance of water hyacinths (Eichhornia crassipes) in treating sugar factory wastewater. The untreated effluent was monitored in a previous crop season to provide baseline composition figures. Four experim...

Tabaczar, S.; Koceva-Chyla, A.; Czepas, J.; Pieniazek, A.; Piasecka-Zelga, J.; Gwozdzinski, K., 2012: Nitroxide pirolin reduces oxidative stress generated by doxorubicin and docetaxel in blood plasma of rats bearing mammary tumor. Combination of doxorubicin (DOX) and docetaxel (DTX) is clinically effective against many drug-refractory cancers, nevertheless, enhanced side effects, e.g. cardiotoxicity related to oxidative damage of tissue macromolecules is observed. Nitroxide...

Robertson K.R., 1973: The krameriaceae in the southeastern usa. Journal of the Arnold Arboretum Harvard University 54(2): 322-327

O.Reilly, R., 1974: Trends in logging mechanisation. Describes changes in New Zealand over the last 30 years, and attempts to predict future trends mainly on the basis of recent developments in other countries.

Lui R.C.; Laregina M.C.; Herbold D.R.; Stern J.A.; Johnson F.E., 1987: Regional doxorubicin delivery reduces testicular toxicity. Many anti-cancer drugs cause infertility. Regional delivery of these agents is a potential method to avoid this problem. We investigated the protective effect of normothermic testicular circulatory arrest on gonadal toxicity during doxorubicin adm...

Ohata, M.; Toda, G., 2002: Gamma-glutamyltranspeptidase (gamma-GT). gamma-GT is a membrane-bound enzyme which plays a role in the metabolism of glutathione and facilitates amino-acid transport. gamma-GT is located in several tissues such as the kidney, pancreas and liver. Serum gamma-GT activity is induced by hepa...

Mueller G.; Gneuss K.D.; Kriemler H P.; Irwin A.J.; Scott A.I., 1981: Structure of factor iii a tri methyl iso bacterio chlorin intermediate in the biosynthesis of vitamin b 12. Factor III, an intermediate in corrin biosynthesis isolated from Propionibacterium shermanii, is shown to be a 3,7,20-trimethylisobacteriochlorin (20-methylsirohydrochlorin) by examination of the CMR [carbon magnetic resonance] spectrum of a biosy...

Chen, S.; Sun, X.; Niu, W.; Kong, L.; He, M.; Li, W.; Zhong, A.; Lu, J.; Zhang, L., 2016: Aberrant Expression of Long Non-Coding RNAs in Schizophrenia Patients. BACKGROUND Dysfunction of long non-coding RNAs (lncRNAs) has been demonstrated to be involved in psychiatric diseases. However, the expression patterns and functions of the regulatory lncRNAs in schizophrenia (SZ) patients have rarely been systema...

Oppenheimer, S.; Oppenheimer, S., 1999: The connection of the female generative organs and laryngeal affections. 1899. Journal of Laryngology and Otology 113(5): 489-489

Wood, E.H.; Sutterer, W.F.; Marshall, H.W.; Lindberg, E.F.; Headley, R.N., 1961: Effect of headward and forward accelerations on the cardiovascular system. The purpose of this research was to measure cardiac output and related physiological variables in human subjects exposed to acceleration stress in various body orientations. Results of these experiments indicate that an average decrease in cardiac...