2009, Número 588
<< Anterior Siguiente >>
Rev Med Cos Cen 2009; 66 (588)
Trombocitopenia inducida por heparina
Leiva HJ
Idioma: Español
Referencias bibliográficas: 23
Paginas: 147-149
Archivo PDF: 219.39 Kb.
RESUMEN
La trombocitopenia inducida por heparina (TIH) es de origen inmunológico y se produce mas frecuentemente tras la exposición a heparina no fraccionada (HNF), aunque se puede dar con el uso de heparina de bajo peso molecular (HBPM). Un porcentaje importante se acompaña de fenómenos tromboticos que pueden llegar a ser mortales si no se tratan adecuadamente. Es mas frecuente en pacientes quirúrgicos que médicos y se produce por anticuerpos de tipo IgG contra complejos de factor 4 plaquetario (PF4) y heparina.
REFERENCIAS (EN ESTE ARTÍCULO)
Amiral J, Bridey F et al. Platelet factor 4 complexed to heparin is the target for antibodies generated in heparin induced trombocitopenia. Thromb Haemost 1992;68:95-6
Fabris F, Luzzato G, Soini B, et al. risk factors for thrombosis in patiets with immune mediated heparin-induced thrombocytopenia. J Intern Med 2002;252:149-54
Fauset MB, vogtlander M. Heparininduced thrombocytopenia is rare in pregnancy. Am J Obstetr Gynecol 2001;185:148-52
Gowthami M, et al. Heparininduced thrombocytopenia. N Eng J Med 2006;355:809-17
Greinacher A, Farner B, Kroll H, Kohlman T, warkentin TE, Eichler P. Clinical features of heparin-induced thrombocytopeniaincluding risk factors for thrombosis: a retrospective analisis of 408 patients. Thromb Haemost 2005;94:132-5
Klenner AF, et al. Heparin induced thrombocytopenia in children: 12 new cases and review of literature. Thromb Haemost 2004;91:719-24
Lewis BE, et al. Argatroban anticoagulant therapy in patients with heparin-induced thrombocitopenia. Circulation 2001;103:1838-43
Linhoff-Last E, Nakov R, Misselvitz F, Breddin HK, Bauersachs R. incidence and clinical relevance of heparin-induced antibodies in patients with deep vein trombosis treated with unfractioned or low molecular-weight heparin. Br J Haematol 2002;118:1137-42
Lubenow N, Eichler P, Lietz T, Greinacher A. Lepirudin in patients with heparin induced thrombocitopenia – results of the third prospective study (HAT-3) and a combined analysis of HAT-2, HAT-2 and HAT-3. J Thromb Haemost 2005;3:2428-36
Martel N, Lee j, Wells PS. Risk for heparin induced thrombocytopenia with unfactioned and low-molecular-weight heparin thromboprophylaxis: a meta-analisis. Blood 2005;106:401-7
O’Shea SI, et al. frequency of antiheparin-platelet factor 4 antibodies in hemodialisis patients and correlation with recurrent vascular access thrombosis. Am J Hematol 2002;69:72-3
Prandoni P, Siragusa S, Girolami B, Fabris F. The incidence of heparin-induced thrombocytopenia in medical patients treated with low molecular weight heparin: a prospective cohort study. Blood 2005;106:3049-54
Wallis DE, Workman DL, Lewis BE, Steen L, Pifarre R, Moran JF. Failure of early heparin cessation as treatment for heparin induced thrombocytopenia. Am J Med 1999;106:629-35
Warkentin TE Heddle NM. Laboratory diagnosis of immune heparin-induced thrombocytopenia. Curr Hematol Rep 2003;2:148-157
Warkentin TE, et al. Heparin-induced thrombocytopenia: recognition, treatment and prevention: the seventh ACCP conference on antithrombic and thrombolytic therapy. Chest 2004;126(3 suppl):311S-337S)
Warkentin TE, et al. Laboratory testing for the antibodies that cause heparin-induced thrombocytopenia: how much class do we need? J Lab Clin Med 2005;146:341-6
Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg 2003;76:2121-2131
Warkentin TE, Kelton JG, Temporal aspects of heparin induced trombocitopenia. N Eng J Med 2001;344:1286-92
Warkentin TE, Robert RS, et al. An improved definition of immune heparin-induced thrombocytopenia in postoperative orthopedic patients. Arch Intern Med 2003;163:2518-2514
Warkentin TE, Sheppard JA, Horsewood P, Simpson PJ, Moore JC, kelton JG. Impact of the patient population on the risk for heparin-induced thrombocytopenia. Blood 2000;96:1703-8
Warkentin TE. Clinical picture of heparin-induced thrombocytopenia. En: Warkentin TE, Greinacher A, eds. Heparin-induced thrombocytopenia. 3rd ed. New York, NY: Marcel Dekker, 2004;53-106
Warkentin TE. Heparin induced skin lesions. Br. J Haematol 1996;92:494-497
Warkentin TE. Heparin-induced thrombocytopenia: pathogenesis and management. Br J Haematol 2003;121:535-555