Document Detail


Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases.
MedLine Citation:
PMID:  19350215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
B Tardy-Poncet; M Wolf; D Lasne; A Bauters; P Ffrench; I Elalamy; B Tardy
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Publication Detail:
Type:  Journal Article     Date:  2009-04-07
Journal Detail:
Title:  Intensive care medicine     Volume:  35     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1449-53     Citation Subset:  IM    
Affiliation:
Hemostasis Department, EA 3065, CHRU, Saint-Etienne 42055, France. brigitte.tardy@chu-st-etienne.fr
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MeSH Terms
Descriptor/Qualifier:
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:
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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