Biological and clinical features of low‐molecular‐weight heparin‐induced thrombocytopenia

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, 1...

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Bibliographic Details
Published in:British journal of haematology 2003-06, Vol.121 (5), p.786-792
Main Authors: Gruel, Yves, Pouplard, Claire, Nguyen, Philippe, Borg, Jeanne‐Yvonne, Derlon, Annie, Juhan‐Vague, Irène, Regnault, Véronique, Samama, Michel
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antibodies - blood
Anticoagulants - adverse effects
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Enzyme-Linked Immunosorbent Assay
Female
Hematologic and hematopoietic diseases
Hematology
Heparin, Low-Molecular-Weight - adverse effects
Humans
low‐molecular‐weight heparin
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Platelet Count
Platelet diseases and coagulopathies
platelet factor 4
Platelet Factor 4 - immunology
Prospective Studies
thrombocytopenia
Thrombocytopenia - chemically induced
thrombosis
Toxicity: blood
unfractionated heparin
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Summary: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
ISSN:0007-1048
1365-2141
DOI:10.1046/j.1365-2141.2003.04363.x