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Heparine induced thrombocytopenia

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https://www.readbyqxmd.com/read/28646118/direct-oral-anticoagulants-for-treatment-of-hit-update-of-hamilton-experience-and-literature-review
#1
Theodore E Warkentin, Menaka Pai, Lori-Ann Linkins
Direct oral anticoagulants (DOACs) are attractive options for treatment of heparin-induced thrombocytopenia (HIT). We report our continuing experience in Hamilton, Canada, since January 1, 2015 (when we completed our prospective rivaroxaban for HIT study) using rivaroxaban for serologically-confirmed HIT (4Ts score ≥4 points, PF4/heparin immunoassay-positive, serotonin-release assay positive). We also performed a literature review of HIT treatment using a DOAC (rivaroxaban, apixaban, dabigatran, edoxaban)...
June 23, 2017: Blood
https://www.readbyqxmd.com/read/28638161/argatroban-for-heparin-induced-thrombocytopenia-during-venovenous-extracorporeal-membrane-oxygenation-with-continuous-venovenous-hemofiltration
#2
Jonathan H Sin, Natasha D Lopez
Patients receiving extracorporeal membrane oxygenation (ECMO) are at risk of circuit thrombosis due to constant contact between blood and the extracorporeal components. Unfractionated heparin has traditionally been used in this setting as a systemic form of anticoagulation to prevent thrombosis of the circuit. However, if a patient develops heparin-induced thrombocytopenia (HIT), an alternative anticoagulant would be required while the patient is maintained on ECMO. Unfortunately, the pharmacokinetic changes induced by ECMO and critical illness may potentially affect optimal drug dosing...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28626145/hydrophilic-polymer-embolism-in-the-lung-as-an-adverse-event%C3%A3-autopsy-case-of-thromboembolisms-in-multiple-organs-associated-with-heparin-induced-thrombocytopenia
#3
Satsuki Komoda, Hiroaki Ozawa, Takeshi Yuasa
No abstract text is available yet for this article.
June 15, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28622439/clinical-effectiveness-of-a-bayesian-algorithm-for-the-diagnosis-and-management-of-heparin-induced-thrombocytopenia
#4
Robert A Raschke, Tyler Gallo, Steven C Curry, Tonya Whiting, Angela Padilla-Jones, Theodore E Warkentin
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a life-threatening drug reaction caused by anti-platelet factor 4/heparin (anti-PF4/H) antibodies. Commercial tests to detect these antibodies have limitations. We previously developed a diagnostic algorithm for HIT that incorporated "four Ts" (4Ts) scoring and a stratified interpretation of an anti-PF4/H enzyme-linked immunosorbent assay (ELISA) and yielded a discriminant accuracy of 0.97 (95% CI: 0.93-1.00). OBJECTIVES: The purpose of this study was to validate the algorithm in an independent patient population and quantitate effects that algorithm adherence could have on clinical care...
June 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28606001/heparin-induced-thrombocytopenia-hit
#5
Natalie S Evans, Marcelo Gomes
No abstract text is available yet for this article.
June 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28604464/liver-transplantation-in-a-patient-with-antiphospholipid-syndrome-a-case-report
#6
Rachel C Steckelberg, Zarah D Antongiorgi, Randolph H Steadman
Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28600720/comparisons-of-argatroban-to-lepirudin-and-bivalirudin-in-the-treatment-of-heparin-induced-thrombocytopenia-a-systematic-review-and-meta-analysis
#7
REVIEW
Zhengwu Sun, Xiaoyan Lan, Shen Li, Hongling Zhao, Zeyao Tang, Yalin Xi
To prevent thromboembolic events associated with heparin-induced thrombocytopenia (HIT), patients usually are treated with argatroban, lepirudin, and bivalirudin. Here, we conducted a meta-analysis of studies to comparing the treatment of HIT with the following direct thrombin inhibitor: argatroban versus lepirudin and argatroban versus bivalirudin. We systematically searched PubMed, Embase, and Cochrane Library database for relevant studies. The clinical outcomes were thromboembolic complication and bleeding...
June 9, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28597462/heparin-induced-thrombocytopenia-in-cardiac-surgery-patients
#8
Allyson M Pishko, Adam Cuker
No abstract text is available yet for this article.
June 8, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28594835/rapid-immunoassays-for-diagnosis-of-heparin-induced-thrombocytopenia-comparison-of-diagnostic-accuracy-reproducibility-and-costs-in-clinical-practice
#9
Andriyana Bankova, Yvonne Andres, Michael P Horn, Lorenzo Alberio, Michael Nagler
BACKGROUND: Immunoassays are crucial in the work-up of patients with suspected heparin-induced thrombocytopenia (HIT) and rapid tests have been recently developed. However, comparative data on diagnostic accuracy, reproducibility, and analytical costs of different immunoassays in clinical practice are limited. METHODS: Samples of 179 consecutive patients evaluated for suspected HIT in clinical practice using a polyspecific enzyme-linked immunoabsorbent assay (GTI diagnostics; ELISA) and a rapid particle gel immunoassay (PaGIA), were additionally analysed with a IgG-specific chemiluminescent immunoassay (AcuStar HIT-IgG)...
2017: PloS One
https://www.readbyqxmd.com/read/28594426/new-developments-in-anticoagulants-past-present-and-future
#10
Jeffrey I Weitz, Job Harenberg
Thrombosis is a leading cause of death and disability worldwide, and anticoagulants are the mainstay of its prevention and treatment. Starting with unfractionated heparin (UFH) and vitamin K antagonists (VKAs) such as warfarin, the choices of anticoagulants have exploded in the past 20 years. With over 90 % subcutaneous bioavailability, no need for coagulation monitoring and dose adjustment, and a lower risk of heparin-induced thrombocytopenia, low-molecular-weight heparin and fondaparinux have replaced UFH for prevention and initial treatment of venous thromboembolism and for secondary prevention in cancer patients...
June 8, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28592259/safety-of-low-molecular-weight-heparin-compared-to-unfractionated-heparin-in-hemodialysis-a-systematic-review-and-meta-analysis
#11
Hind Harrak Lazrak, Émilie René, Naoual Elftouh, Martine Leblanc, Jean-Philippe Lafrance
BACKGROUND: Low molecular weight heparins (LMWH) have been extensively studied and became the treatment of choice for several indications including pulmonary embolism. While their efficacy in hemodialysis is considered similar to unfractionated heparin (UFH), their safety remains controversial mainly due to a risk of bioaccumulation in patients with renal impairment. The aim of this systematic review was to evaluate the safety of LMWH when compared to UFH for extracorporeal circuit (ECC) anticoagulation...
June 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28589046/coexistence-of-antiphospholipid-syndrome-and-heparin-induced-thrombocytopenia-in-a-patient-with-recurrent-venous-thromboembolism
#12
Samuel Adediran, Nicole Agostino
Heparin-induced thrombocytopenia (HIT) is a prothrombotic adverse drug reaction in which heparin forms complexes with platelet factor 4 forming neoantigens that are recognized by autoantibodies. Antiphospholipid syndrome (APS) is similar to HIT in that it is mediated by autoantibodies that are also prothrombotic. We present a case of rare coexistence of antiphospholipid antibody syndrome and heparin-induced thrombocytopenia.
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28579599/bilateral-arm-gangrene-associated-with-heparin-induced-thrombocytopenia-after-extracorporeal-cardiopulmonary-resuscitation
#13
Kansuke Ito, Toshiaki Isogai, Makiko Takada, Tetsushi Tatsumi, Kazuaki Enatsu, Hiroyuki Tanaka, Tamotsu Tejima
No abstract text is available yet for this article.
June 3, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28576265/incidence-and-outcomes-of-heparin-induced-thrombocytopenia-in-patients-undergoing-transcatheter-aortic-valve-replacement
#14
Tesfaye Telila, Emmanuel Akintoye, Tomo Ando, Obsinet Merid, Sagar Mallikethi-Reddy, Alexandros Briasoulis, Cindy Grines, Luis Afonso
The main objective of this study was to investigate the incidence and magnitude of impact of heparin-induced thrombocytopenia (HIT) on outcomes of patients undergoing transcatheter aortic valve placement (TAVR). The impact of HIT on procedural outcomes after cardiac surgery has been described. We sought to investigate the incidence and outcomes of HIT after TAVR using the Nationwide Inpatient Sample (NIS) database. We identified patients who underwent TAVR from 2011 to 2014. The primary outcome was the effect of HIT on inpatient mortality...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28544026/immobilization-and-high-platelet-count-are-associated-with-thromboembolic-complications-in-heparin-induced-thrombocytopenia
#15
Juliane Bolbrinker, Edeltraut Garbe, Antonios Douros, Matthias Huber, Elisabeth Bronder, Andreas Klimpel, Frank Andersohn, Oliver Meyer, Abdulgabar Salama, Reinhold Kreutz
PURPOSE: Immune-mediated heparin-induced thrombocytopenia (HIT type II, HIT) is a potentially serious adverse drug reaction characterized by an increased risk of venous and arterial thrombosis. This study aimed to identify risk factors associated with the development of these complications. METHODS: Our study cohort included patients with HIT assembled in our pharmacovigilance center by reports from 51 collaborating hospitals in Berlin, Germany. To identify risk factors for thromboembolic complications, patients with thromboembolic events (cases) were compared to those without thromboembolic events (controls) in a case-control design...
May 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28530237/anti-platelet-factor-4-polyanion-antibodies-mediate-a-new-mechanism-of-autoimmunity
#16
Thi-Huong Nguyen, Nikolay Medvedev, Mihaela Delcea, Andreas Greinacher
Antibodies recognizing complexes of the chemokine platelet factor 4 (PF4/CXCL4) and polyanions (P) opsonize PF4-coated bacteria hereby mediating bacterial host defense. A subset of these antibodies may activate platelets after binding to PF4/heparin complexes, causing the prothrombotic adverse drug reaction heparin-induced thrombocytopenia (HIT). In autoimmune-HIT, anti-PF4/P-antibodies activate platelets in the absence of heparin. Here we show that antibodies with binding forces of approximately 60-100 pN activate platelets in the presence of polyanions, while a subset of antibodies from autoimmune-HIT patients with binding forces ≥100 pN binds to PF4 alone in the absence of polyanions...
May 22, 2017: Nature Communications
https://www.readbyqxmd.com/read/28491219/-a-non-edta-dependent-pseudothrombocytopenia-about-a-case
#17
Hicham Titou, Youssef Jalal, Mohammed Boui
Pseudothrombocytopenia is a rare phenomenon in laboratory explained by in vitro agglutination of platelets. Microscopic examination of the peripheral blood smear is of key importance to confirm the diagnosis and to avoid any inappropriate or dangerous clinical and therapeutic decision. Its occurrence in a patient, under treatment with heparin, raises the problem of differential diagnosis of heparin-induced thrombocytopenia. The aim of this study was to eliminate any confusion between this purely artefactual phenomenon and heparin-induced thrombocytopenia...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28487841/bullous-hemorrhagic-dermatosis-due-to-enoxaparin-use-in-a-bullous-pemphigoid-patient
#18
Ji-Su Shim, Soo Jie Chung, Byung-Keun Kim, Sae-Hoon Kim, Kyu Sang Lee, Yeonyee E Yoon, Yoon-Seok Chang
Adverse reactions of subcutaneous low molecular weight heparin or unfractionated heparin could be complications by bleeding, heparin-induced thrombocytopenia, drug-induced liver injury, osteoporosis, and cutaneous reactions. Heparin-induced skin lesions vary from allergic reactions like erythema, urticaria, eczema to intradermal microvascular thrombosis associated with heparin-induced thrombocytopenia. There is a rare cutaneous complication, called bullous hemorrhagic dermatosis. We experienced this rare case of the cutaneous complication caused by enoxaparin...
April 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/28465848/extensive-intracardiac-and-deep-venous-thromboses-in-a-young-woman-with-heparin-induced-thrombocytopenia-and-may-thurner-syndrome
#19
Yekaterina Kim, Daniel C Choi, Ali N Zaidi
A 38-year-old woman with a history of recurrent deep venous thromboses (DVTs) on chronic anticoagulation presented with acute left leg swelling. The patient was diagnosed with an acute left lower extremity (LLE) DVT in the setting of May-Thurner syndrome for which treatment with unfractionated heparin was started. Her hospital course was complicated by a new diagnosis of heparin-induced thrombocytopenia (HIT), with an incidental discovery of a large tricuspid valve mobile mass on a transthoracic echocardiogram (TTE)...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28447421/clinical-decision-support-for-hematology-laboratory-test-utilization
#20
REVIEW
R Jackups, J J Szymanski, S P Persaud
Clinical decision support (CDS) is the use of information and communication technologies to improve clinical decision making and patient care. CDS applications have been used in many aspects of health care, including medication ordering and diagnostic prediction algorithms. As economic and regulatory pressures place a strain on laboratory resources, the potential of CDS to improve utilization of laboratory testing has also begun to be realized. Hematology and coagulation laboratories stand to gain tremendously from the implementation of CDS interventions, given their mixture of high-volume, low-cost tests (eg CBC, PT, aPTT) and tests that carry a high potential of being misused or misinterpreted (eg lupus anticoagulant, erythrocyte sedimentation rate, heparin-induced thrombocytopenia testing)...
May 2017: International Journal of Laboratory Hematology
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