| Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases. | |
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MedLine Citation:
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PMID: 19350215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Danaparoid is a safe and effective drug for the treatment of heparin-induced thrombocytopenia (HIT). We describe an uncommon complication: danaparoid cross-reactivity with HIT antibodies. DESIGN AND SETTING: A retrospective observational multicenter study on HIT was conducted in France. In this study concerning HIT patients treated with lepirudin, 12 patients were treated with lepirudin because danaparoid cross-reacted with the heparin-dependent antibodies. RESULTS: Three groups of situations can be separated. In a first group, four patients received a short course of danaparoid until their initial functional HIT assay showed a cross-reactivity between danaparoid and HIT antibodies. One patient presented a fatal thrombotic complication but the relationship between this thrombotic complication and danaparoid cross-reactivity cannot be certain. In a second group, four patients received for 4 days at least a danaparoid treatment while the initial functional test did not show any danaparoid cross-reactivity. During danaparoid treatment, no significant increase of platelet count was observed and two patients presented a fatal thrombotic complication. In a third group, cross-reactivity between danaparoid and HIT antibodies was not checked before danaparoid therapy. During danaparoid treatment, no significant increase of platelet count was observed and the four patients developed a venous thromboembolic complication. CONCLUSION: Absence of any increase in platelet count after 3 to 5 days of danaparoid therapy and/or the occurrence of a new thrombotic event should lead to danaparoid cross-reactivity suspicion. However, before attributing thrombotic complications to danaparoid cross-reactivity, it is crucial to verify that the patients received the recommended danaparoid dosage regimen. |
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Authors:
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B Tardy-Poncet; M Wolf; D Lasne; A Bauters; P Ffrench; I Elalamy; B Tardy |
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Publication Detail:
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Type: Journal Article Date: 2009-04-07 |
Journal Detail:
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Title: Intensive care medicine Volume: 35 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-20 Completed Date: 2009-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1449-53 Citation Subset: IM |
Affiliation:
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Hemostasis Department, EA 3065, CHRU, Saint-Etienne 42055, France. brigitte.tardy@chu-st-etienne.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / administration & dosage, adverse effects*, pharmacology, therapeutic use Chondroitin Sulfates / administration & dosage, pharmacology*, therapeutic use Cross Reactions Dermatan Sulfate / administration & dosage, pharmacology*, therapeutic use Female Hemostasis / drug effects Heparin / administration & dosage, adverse effects*, pharmacology, therapeutic use Heparitin Sulfate / administration & dosage, pharmacology*, therapeutic use Hirudins Humans Intensive Care Units Male Middle Aged Purpura, Thrombocytopenic, Idiopathic / chemically induced*, immunology Recombinant Proteins / therapeutic use Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Hirudins; 0/Recombinant Proteins; 0/lepirudin; 24967-94-0/Dermatan Sulfate; 83513-48-8/danaproid; 9005-49-6/Heparin; 9007-28-7/Chondroitin Sulfates; 9050-30-0/Heparitin Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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