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.
Resumen
Heparin-induced thrombocytopenia treated with fondaparinux: single center experience.
Por qué esto importa para la hirudoterapia
Este estudio de cohorte unicéntrico describió 10 pacientes (8 varones, 2 mujeres; edad media de 67 años) diagnosticados con trombocitopenia inducida por heparina (HIT) entre 2014 y 2018 y tratados con fondaparinux, informando recuperación plaquetaria completa en todos los casos y concluyendo que el fondaparinux resultó seguro y eficaz, incluso en dos pacientes con insuficiencia renal grave. Para ASH y la hirudoterapia, el estudio es relevante porque el resumen cita explícitamente la lepirudina —un derivado recombinante de la hirudina presente en la saliva de la sanguijuela medicinal— como anticoagulante alternativo estándar para la HIT, situando este trabajo dentro del panorama clínico más amplio de las terapias basadas en hirudina y sus alternativas. Comprender cómo se comportan los distintos anticoagulantes en la HIT informa la toma de decisiones sobre cuándo los inhibidores directos de la trombina derivados de la sanguijuela pueden emplearse o sustituirse. No obstante, se trata de una serie observacional pequeña y no controlada, realizada en una sola institución y sin brazo comparador, por lo que los hallazgos son generadores de hipótesis más que evidencia definitiva respecto al fondaparinux en relación con la lepirudina u otros agentes.
Citación
Heparin-induced thrombocytopenia treated with fondaparinux: single center experience
Dulicek P et al. · International angiology, 2019
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026