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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2007, Number 4

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An Med Asoc Med Hosp ABC 2007; 52 (4)

Heparin-induced thrombocytopenia syndrome. Physiopathogenesis and treatment, actual concepts

Morales PMR, López-Velarde BP, Gómez ME, Murillo MEE

Language: Spanish
References: 34
Page: 192-197
PDF size: 120.12 Kb.


ABSTRACT

Heparin-induced thrombocytopenia is a syndrome characterized by thrombocytopenia, thrombosis or both; it appears with standard heparin or low molecular weight heparin. The syndrome is more frequent with standard heparin (average 6.5%) than low molecular weight heparin (‹1%). Heparin- induced thrombocytopenia depends on the source of origin of heparin, time of exposure, study population and gender. There are a variety of clinical manifestations, the most critical are venous or arterial thrombosis. The pathogenesis includes the formation of antibodies against heparin-platelet factor 4 complex, this activates platelets, endothelium, inflammatory cells and cytokines that cause paradoxical thromboses. Treatment is based on early diagnosis, heparin withdrawal, use of direct inhibitors of thrombin like lepidurin and argatroban, or factor Xa inhibitors as danaparoid or fondaparinux. Heparin-induced thrombocytopenia is a syndrome that always needs to be kept in mind whenever heparin is used; it's important to avoid the excessive use of heparin, and to identify in a timely fashion the manifestations of the syndrome to establish an effective diagnosis and treatment.


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