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Heparine induced thrombocytopenia

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https://www.readbyqxmd.com/read/29776985/tkaczynski-e-arulselvan-a-tkaczynski-j-et-al-2-o-3-o-desulfated-heparin-mitigates-murine-chemotherapy-and-radiation-induced-thrombocytopenia-blood-adv-2018-2-7-754-761
#1
https://www.readbyqxmd.com/read/29756276/a-novel-diagnostic-algorithm-for-heparin-induced-thrombocytopenia
#2
G Zheng, M B Streiff, D Allison, C M Takemoto, K Salimian, P Morris, J Jani, R McCord, T S Kickler
INTRODUCTION: While diagnostic algorithm using PF4-heparin enzyme-linked immunosorbent assay (ELISA) optical density (OD), and heparin neutralization assay (HNA), or 4T score have been proposed to replace serotonin-release assay (SRA) for heparin-induced thrombocytopenia (HIT), their performance against SRA is unclear. In this study, we proposed and validated the performance of a new algorithm combining PF4-heparin ELISA optical density (OD), HNA and 4T score against SRA for HIT diagnosis...
May 13, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29744595/synthesis-and-biocompatibility-of-an-argatroban-modified-polysulfone-membrane-that-directly-inhibits-thrombosis
#3
Xiao Fu, Jian-Ping Ning
Anticoagulation therapy plays a vital role in the prevention of blood clot formation during hemodialysis and hemofiltration, especially for critical care patients. Here, we synthesized a novel argatroban (Arg)-modified polysulfone (PSf) membrane for anticoagulation. Arg was grafted onto the PSF membrane via chemical modification to increase membrane hydrophilicity. Protein adsorption, coagulation, as well as activation of platelets and complement systems were greatly reduced on the Arg-modified PSf membrane...
May 9, 2018: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29723924/cellular-immune-responses-to-platelet-factor-4-and-heparin-complexes-in-patients-with-heparin-induced-thrombocytopenia
#4
Ishac Nazy, Rumi Clare, Phillip Staibano, Theodore E Warkentin, Mark Larche, Jane C Moore, James W Smith, Richard P Whitlock, John G Kelton, Donald M Arnold
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse reaction to heparin characterized by thrombocytopenia and thrombotic complications. HIT is caused by pathogenic antibodies that bind to complexes of platelet factor 4 and heparin (PF4/heparin) leading to platelet activation and inducing a hypercoagulable state. Previous studies have shown immunity to PF4/heparin occurs early in life even before heparin exposure; however, the immunogenesis of HIT is not well characterized...
May 3, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29707901/argatroban-is-stable-in-citrated-whole-blood-for-24-hours
#5
S Guy, S Kitchen, J J Van Veen
INTRODUCTION: Argatroban is a direct thrombin inhibitor used as an anticoagulant for patients who have Heparin induced thrombocytopenia. Quantification can be performed using a dilute thrombin time or anti-iia assay. Our preferred method is Hemoclot Thrombin Inhibitor Assay (HTI).To the best of our knowledge, no one has published on the stability of plasma argatroban in whole citrated blood at room temperature. METHODS: Forty matched samples obtained from 4 patients receiving argatroban...
April 29, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29703478/management-of-recurrent-venous-thromboembolism-in-patients-with-cancer-a-review
#6
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE) occurs in 10-20%% of patients with cancer and is associated with significant mortality and morbidity in these patients. The current standard of care recommended by international guidelines is to use low-molecular-weight heparin (LMWH) for 6months for the management of cancer-associated thrombosis (CAT), which is based on evidence from randomized controlled trials demonstrating that LMWH significantly reduced the risk of recurrent VTE compared with vitamin K antagonists. However, patients with CAT have a high risk of VTE recurrence of up to 20% despite receiving anticoagulation...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29703336/disease-burden-complication-rates-and-health-care-costs-of-heparin-induced-thrombocytopenia-in-the-usa-a-population-based-study
#7
Binod Dhakal, Lisa Baumann Kreuziger, Lisa Rein, Ariel Kleman, Raphael Fraser, Richard H Aster, Parameswaran Hari, Anand Padmanabhan
BACKGROUND: Heparin-induced thrombocytopenia can be a life-threatening and limb-threatening complication of heparin therapy. Incidence and complication rates of this condition have been extrapolated from studies with modest sample sizes, and despite the availability of therapeutic interventions the outcomes of heparin-induced thrombocytopenia are not well understood. We aimed to estimate disease burden, complication rates, and costs of heparin-induced thrombocytopenia in the USA. METHODS: In this population-based study we analysed data from 2009 to 2013 from the Nationwide (National) Inpatient Sample (NIS), a large, all-payer inpatient health-care database in the USA...
May 2018: Lancet Haematology
https://www.readbyqxmd.com/read/29703334/analysis-of-big-data-for-heparin-induced-thrombocytopenia-valuable-information-but-also-some-doubts
#8
Yves Gruel
No abstract text is available yet for this article.
May 2018: Lancet Haematology
https://www.readbyqxmd.com/read/29697459/the-effect-of-obesity-on-the-rate-of-heparin-induced-thrombocytopenia
#9
Jacob L Marler, G Morgan Jones, Brian J Wheeler, Abdulrahman Alshaya, Jonathan L Hartmann, Carrie S Oliphant
: Heparin-induced thrombocytopenia (HIT) occurs in patients receiving heparin-containing products due to the formation of platelet-activating antibodies to heparin and platelet factor 4. Diagnosis includes utilization of a scoring system known as the 4-T score, and HIT laboratory assays. Recently, obesity was identified as a potential factor associated with the development of HIT. The objective of this study was to evaluate the association of HIT with obesity in ICU and general medicine patients. We performed a chart review of adult patients within the Methodist Healthcare System, and included patients who had an ELISA and serotonin release assay laboratory tests reported within same hospital admission in which they also had documented receipt of heparin...
April 24, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29683226/low-incidence-of-heparin-induced-skin-lesions-in-orthopedic-surgery-patients-with-low-molecular-weight-heparins
#10
M Schindewolf, M Paulik, H Kroll, R Kaufmann, M Wolter, W-H Boehncke, E Lindhoff-Last, A Recke, R J Ludwig
BACKGROUND: Heparins are widely prescribed for prevention and therapy of arterial and venous thromboembolic diseases. Heparin-induced skin lesions are the most frequent adverse effects of subcutaneous heparin treatment in non-surgical patients (7.5-39.8%); no data exist on surgical patients. Commonly, they are due to a delayed-type hypersensitivity reaction (DTH), but may also be a manifestation of life-threatening heparin-induced thrombocytopenia (HIT). Lesions of both entities resemble initially...
April 23, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29678479/hit-or-miss-a-comprehensive-contemporary-investigation-of-laboratory-tests-for-heparin-induced-thrombocytopenia
#11
Emmanuel J Favaloro, Georgia McCaughan, Soma Mohammed, Kun Kan Edwin Lau, Rosalie Gemmell, Lauren Cavanaugh, Dea Donikian, Mayuko Kondo, Timothy Brighton, Leonardo Pasalic
Heparin induced thrombocytopenia (HIT) is a rare but potentially fatal complication of heparin therapy, which in a proportion of patients causes platelet activation and thrombosis. Initial clinical assessment of the likelihood of HIT is facilitated by laboratory testing to confirm or exclude HIT. This prospective investigation was performed over an 18-month period, and has involved testing of over 300 test samples from over 100 consecutive patients. Clinical assessment by 4T score was supplemented by laboratory tests that comprised both immunological [lateral flow ('STiC'), chemiluminescence (AcuStar; HIT-IgG(PF4-H) ), ELISA (Asserachrom HPIA IgG)] and functional assays [SRA, platelet aggregation using whole blood ('Multiplate') and platelet rich plasma ('LTA')]...
April 17, 2018: Pathology
https://www.readbyqxmd.com/read/29677409/is-there-an-association-between-heparin-induced-thrombocytopenia-hit-and-autoimmune-disease
#12
Brent Klinkhammer, Michael Gruchalla
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a drug-induced, immunoglobulin G medicated autoimmune disorder associated with several negative clinical outcomes including increased morbidity, mortality, and increased medical costs. Previous studies have shown associations between comorbid autoimmune diseases, but there is little known about associations between HIT and autoimmunity. PURPOSE: To provide clinical data to suggest an association between HIT and autoimmunity...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29665860/the-use-of-cangrelor-with-heparin-for-left-ventricular-assist-device-implantation-in-a-patient-with-acute-heparin-induced-thrombocytopenia
#13
Yan K Gernhofer, Michael Ross, Swapnil Khoche, Victor Pretorius
BACKGROUND: Optimal anticoagulation strategy for cardiopulmonary bypass (CPB) in end-stage heart failure patients with heparin-induced thrombocytopenia (HIT) requiring left ventricular assist device (LVAD) implantation remains uncertain. Presently, there are no large-scale randomized studies comparing outcomes of alternative anticoagulation strategies for CPB in this patient population. A novel antiplatelet agent - cangrelor, which is a potent P2Y12 inhibitor with robust antiplatelet efficacy, rapid reversibility, and measurable drug effect, has become available since 2015...
April 17, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29661682/absolute-immature-platelet-counts-in-the-setting-of-suspected-heparin-induced-thrombocytopenia-may-predict-anti-pf4-heparin-immunoassay-testing-results
#14
Wei Chen, Jennifer P Ha, Hong Hong, Robert W Maitta
BACKGROUND: Heparin-induced-thrombocytopenia (HIT) is a disease mediated by antibodies to platelet factor 4 (PF4)-heparin complexes. Immature platelet fraction (%-IPF) and absolute immature platelet count (A-IPC) measure newly-released platelets into circulation and can prove useful in differentiating patients with thrombocytopenic presentations due to consumptive or hypoproduction processes. Therefore, we evaluated utility of A-IPC in a cohort of thrombocytopenic patients suspected of HIT...
April 11, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29649767/heparin-induced-thrombocytopenia-a-critical-appraisal-of-clinical-practice-guidelines-with-the-agree-ii-instrument
#15
Ying Wang, Zhi-Kang Ye, Ji-Feng Li, Xiang-Li Cui, Li-Hong Liu
BACKGROUND: Despite the availability of clinical practice guidelines (CPGs), the risk of death or thromboembolic complication associated with heparin-induced thrombocytopenia (HIT) remains high. Our aim was to systematically review the quality of CPGs for HIT and summarize the recommendations. METHODS: CPGs for HIT were systematically searched on PubMed, Embase, guidelines' websites, and Google up to August 6, 2017. Independently, three appraisers assessed the quality of CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and extracted the data...
March 27, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29628468/induction-of-anti-pf4-heparin-antibodies-after-arthroplasty-for-rheumatic-diseases
#16
Kiyoshi Migita, Tomoyuki Asano, Shuzo Sato, Satoru Motokawa
Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. These pathogenic antibodies against PF4/heparin bind and activate cellular FcγRIIa on platelets to induce a hypercoagulable state culminating in thrombosis. Recent studies indicate several conditions, including joint surgery, induce spontaneous HIT, which can occur without exposure to heparin. To determine the real-world evidences concerning the incidences of venous thromboembolism (VTE) after total joint arthroplasty for rheumatic disease, we conducted a multicenter cohort study (J-PSVT) designed to document the VTE and seroconversion rates of anti-PF4/heparin antibody in 34 Japanese National hospital organization (NHO) hospitals...
April 7, 2018: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/29622761/simultaneous-pancreas-kidney-transplantation-in-a-patient-with-heparin-induced-thrombocytopenia-on-dabigatran-therapy
#17
Agnieszka Jóźwik, Wojciech Lisik, Jarosław Czerwiński, Maciej Kosieradzki
BACKGROUND New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency...
April 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29614814/the-role-of-single-molecule-force-spectroscopy-in-unraveling-typical-and-autoimmune-heparin-induced-thrombocytopenia
#18
REVIEW
Van-Chien Bui, Thi-Huong Nguyen
For the last two decades, heparins have been widely used as anticoagulants. Besides numerous advantages, up to 5% patients with heparin administration suffer from a major adverse drug effect known as heparin-induced thrombocytopenia (HIT). This typical HIT can result in deep vein thrombosis, pulmonary embolism, occlusion of a limb artery, acute myocardial infarct, stroke, and a systemic reaction or skin necrosis. The basis of HIT may lead to clinical insights. Recent studies using single-molecule force spectroscopy (SMFS)-based atomic force microscopy revealed detailed binding mechanisms of the interactions between platelet factor 4 (PF4) and heparins of different lengths in typical HIT...
April 2, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29605959/heparin-induced-thrombocytopenia-in-infants-after-heart-surgery
#19
Juma N Abdillah, Qinghua Hu, Xuliang Chen, Xing Chen, Wu Zhou, Wanjun Luo, Lingjin Huang
BACKGROUND:  Heparin-induced thrombocytopenia (HIT) in infants is a rare disorder, and the diagnosis and management of HIT still remains challenging. Argatroban is a synthetic direct thrombin inhibitor (DTI) that is widely used for treating HIT. However, little is known about the efficacy of the activated clotting time (ACT) test in monitoring DTI treatment as an alternative to the routinely used activated partial thromboplastin time (aPTT). METHODS:  Between July 2013 and January 2015, four infants were diagnosed with HIT after surgical correction of congenital anomalies...
April 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29600212/upper-limb-phlegmasia-cerulea-dolens-secondary-to-heparin-induced-thrombocytopenia-a-case-study
#20
Matthew Gaines, Mike Grant, Simon Robinson, Helene Stevenson
Introduction: Phlegmasia cerulea dolens (PCD) is a rare pathology with a very high morbidity and mortality rate, which usually occurs in the lower limb. There is very little literature available to aid management. Case Report: We present a case of upper limb PCD in a 67-year-old female secondary to heparin-induced thrombocytopenia caused by warfarin bridging. She presented to the orthopedic team with upper limb compartment syndrome from a bleed around a peripherally inserted central catheter, for which she was urgently taken to the theater for fasciotomies...
November 2017: Journal of Orthopaedic Case Reports
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