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Accession number;05A0625471
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| Title;Present Aspect of Heparin-induced Thrombocytopenia |
| Author;
MATSUO MIYAKO
(Hyogo Prefect. Awaji Hosp.)
WANAKA KEIKO
(Kessenshiketsukenkyukobepurojekuto)
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Journal Title;Japanese Journal of Intensive Care Medicine
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Journal Code:Z0581B
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ISSN:0389-1194
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VOL.29;NO.5;PAGE.361-369(2005)
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| Figure&Table&Reference;FIG.5, TBL.4, REF.10 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Heparin is commonly applied as a suitable anticoagulant in clinical settings. Heparin has serious side effects on bleeding and thrombocytopenia. The later is well recognized as heparin-induced thrombocytopenia (HIT). Pathogenesis of HIT is antibody formation against heparin and platelet factor 4 (PF 4) complexes. The antibody binds and activates platelets. Activated platelets release procoagulant substances into circulation. And hypercoagulable state is induced and thrombosis associated with thrombocytopenia occasionally develops. Finding of HIT depends on recognition that HIT may occur in about 1-3% in heparin treated patients. In Japan, HIT case reports are increasing year after year in the field of hemodialysis and cardiology. Diagnosis of HIT is easily done by thrombocytopenia during and after heparin infusion. Conformation of HIT diagnosis is made by use of the antibody detection. Treatment should start at the time of suspected HIT and continue until proving result of the test. Treatment strategy to HIT starts alternative direct thrombin inhibitor to heparin. Argatorban is chosen as first line alternative in Japan. HIT is always kept in mind when a high risk patient suffered from thrombosis would be treated with heparin anticoagulation. (author abst.) |
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