Abstract
A prospective study of 104 patients receiving heparin obtained from porcine intestinal mucosa for 4 or more days was conducted to determine the frequency of associated significant thrombocytopenia (platelet count less than 100 x 10(9)/I on 2 consecutive days). No episodes of significant thrombocytopenia were identified in the 13 patients receiving heparin by continuous intravenous infusion for a mean of 8.0 days or in the 38 patients receiving heparin subcutaneously for a mean of 9.9 days. In 1 of the 26 patients receiving heparin as intermittent intravenous boluses for a mean of 8.2 days significant thrombocytopenia developed; this patient had laboratory evidence of disseminated intravascular coagulation. In none of the 17 patients receiving uninterrupted heparin therapy for 4 or more days by more than one route of administration but for less than 4 days by any single route did significant heparin-associated thrombocytopenia develop. Of the 104 patients 13 had one or more platelet counts of less than 150 x 10(9)/I, but in most it was not possible to definitely relate the thrombocytopenia to the heparin therapy. Platelets in normal platelet-rich plasma did not aggregate when heparin and serum from patients with thrombocytopenia were added. The frequency of heparin-associated thrombocytopenia noted in this study was considerably lower than that reported previously.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Babcock R. B., Dumper C. W., Scharfman W. B. Heparin-induced immune thrombocytopenia. N Engl J Med. 1976 Jul 29;295(5):237–241. doi: 10.1056/NEJM197607292950501. [DOI] [PubMed] [Google Scholar]
- Bell W. R., Tomasulo P. A., Alving B. M., Duffy T. P. Thrombocytopenia occurring during the administration of heparin. A prospective study in 52 patients. Ann Intern Med. 1976 Aug;85(2):155–160. doi: 10.7326/0003-4819-85-2-155. [DOI] [PubMed] [Google Scholar]
- Deykin D., Hellerstein L. J. The assessment of drug-dependent and isoimmune antiplatelet antibodies by the use of platelet aggregometry. J Clin Invest. 1972 Dec;51(12):3142–3153. doi: 10.1172/JCI107141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fratantoni J. C., Pollet R., Gralnick H. R. Heparin-induced thrombocytopenia: confirmation of diagnosis with in vitro methods. Blood. 1975 Mar;45(3):395–401. [PubMed] [Google Scholar]
- GOLLUB S., ULIN A. W. Heparin-induced thrombocytopenia in man. J Lab Clin Med. 1962 Mar;59:430–435. [PubMed] [Google Scholar]
- Hrushesky W. Thrombocytopenia induced by low-dose subcutaneous heparin. Lancet. 1977 Dec 17;2(8051):1286–1286. doi: 10.1016/s0140-6736(77)92693-9. [DOI] [PubMed] [Google Scholar]
- Klein H. G., Bell W. R. Disseminated intravascular coagulation during heparin therapy. Ann Intern Med. 1974 Apr;80(4):477–481. doi: 10.7326/0003-4819-80-4-477. [DOI] [PubMed] [Google Scholar]
- Natelson E. A., Lynch E. C., Alfrey C. P., Jr, Gross J. B. Heparin-induced thrombocytopenia. An unexpected response to treatment of consumption coagulopathy. Ann Intern Med. 1969 Dec;71(6):1121–1125. doi: 10.7326/0003-4819-71-6-1121. [DOI] [PubMed] [Google Scholar]
- Nelson J. C., Lerner R. G., Goldstein R., Cagin N. A. Heparin-induced thrombocytopenia. Arch Intern Med. 1978 Apr;138(4):548–552. [PubMed] [Google Scholar]
- Rhodes G. R., Dixon R. H., Silver D. Heparin induced thrombocytopenia with thrombotic and hemorrhagic manifestations. Surg Gynecol Obstet. 1973 Mar;136(3):409–416. [PubMed] [Google Scholar]
- Searcy T. A., Marple R. N. Heparin and thrombocytopenia. Ann Intern Med. 1977 Mar;86(3):364–364. doi: 10.7326/0003-4819-86-3-364_2. [DOI] [PubMed] [Google Scholar]