Heparin-induced thrombocytopenia treated with fondaparinux: single center experience
Research article published in International angiology (2019)
Abstract
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is the most frequent drug-induced, immune-mediated thrombocytopenia. It is associated with significant morbidity and mortality. Anticoagulation with heparin must be stopped immediately and replaced by some suggested alternative - lepirudin, danaparoid or argatroban. Fondaparinux has been also successfully used in HIT. METHODS: We present a cohort of 10 patients diagnosed with HIT and treated in a university hospital in a period of four years. Diagnosis was based on Keeling´s scoring system, screening immunologic test for HIT (STic EXPERT® HIT) and sandwich ELISA (detection of IgG/heparin-PF4 antibodies). While other alternative anticoagulants are not readily available in our hospital, we used fondaparinux in all cases. RESULTS: From 2014 to 2018, eight males and two females (mean age 67 years, range 46-86 years) were diagnosed with HIT in our hospital. This complication developed in 9 cases after low-molecular-weight heparin and in one after heparin flushes in hemodialysis. A drop-in platelet count developed in all patients, thrombotic complications in 7 and skin necrosis in 2 cases. Fondaparinux was used in all patients, including two cases with severe renal impairment, the dose was chosen individually. We observed complete platelet recovery in all cases. One patient died because of advanced malignancy, others did not have any complication. In 6 cases we switched to oral anticoagulation after platelet recovery. CONCLUSIONS: In our group of 10 HIT patients fondaparinux was shown to be both safe and effective, even in those with severe renal impairment. Additional studies are warranted to confirm this observation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Heparin-induced thrombocytopenia treated with fondaparinux: single center experience.
Warum dies für die Hirudotherapie relevant ist
This single-center cohort study describes 10 patients diagnosed with heparin-induced thrombocytopenia (HIT) over a four-year period who were treated with fondaparinux. The abstract mentions lepirudin, danaparoid, and argatroban as alternative anticoagulants that were not readily available at the institution, though fondaparinux showed complete platelet recovery in all patients, including those with severe renal impairment. The study does not mention leeches, hirudin, or leech therapy. Because the provided text treats all medications solely as conventional pharmaceuticals without describing their biological origins, this article has no defensible relevance to ASH's domain of hirudotherapy or the leech secretome.
Zitation
Heparin-induced thrombocytopenia treated with fondaparinux: single center experience
Dulicek P et al. · International angiology, 2019
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