Key result
Heparin, LMWH, and analogues induce platelet aggregation in a HIT case regardless of molecular weight.
Why the study?
Platelet aggregation induced by standard heparin, LMWH fractions, or semi-synthetic analogues in heparin-induced thrombocytopenia patients is not fully understood.
Does exposure to various heparin fractions and analogues induce platelet aggregation in a patient with heparin-induced thrombocytopenia?
Case Report (n=1)
Does exposure to various heparin fractions and analogues induce platelet aggregation in a patient with heparin-induced thrombocytopenia?
Platelet aggregation in heparin-induced thrombocytopenia can be induced by standard heparin and certain LMWH fractions or analogues independently of their molecular weight and anticoagulant activity.
Answers are grounded in this paper and cite their sources.
Single-case in vitro aggregation data do not support LMWH selection in HIT; leaves open need for clinical validation.
One case of heparin-induced thrombocytopenia is reported. Aggregation was observed in the platelet-rich plasma of this patient in the presence of two commercial standard heparin preparations (from a final concentration of 0.025 IU/ml upwards), of two semi-synthetic heparin analogues (0.1 APTT U/ml) and of three low-molecular weight heparin (LMWH) fractions (0.1 anti-Xa U/ml) but not in the presence of five other LMWH fractions. The patient's isolated platelets no longer aggregated in the The patient's isolated platelets no longer aggregated in the presence of heparin but the phenomenon recurred after addition of the patient's platelet poor plasma (PPP). Furthermore, addition of patient's PPP to control platelets led to heparin-induced aggregation. The phenomenon was associated with thromboxane generation and could be blocked by in vitro addition of aspirin, PGI2, and PGD2 whereas the lag phase was dose-dependently prolonged by adenosine. It is concluded that platelet aggregation may be induced in some patients by standard heparin and by certain LMWH fractions or semi-synthetic analogues, independently of their molecular weight and anticoagulant activity.
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Blockmans et al. (1986) conducted a case report in Heparin-induced thrombocytopenia (n=1). Heparin fractions and semi-synthetic analogues was evaluated on Platelet aggregation. In a patient with heparin-induced thrombocytopenia, platelet aggregation was induced by standard heparin, certain LMWH fractions, and semi-synthetic analogues, independently of molecular weight.
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