Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia
2010
Autori
Antonijević, NebojšaRadovanović, Nebojša
Obradović, Slobodan
Vucelić, Dragica
Stojanović, Bojan
Miković, Danijela
Kovač, Mirjana
Kocica, Tina
Tadić, Svetlana
Antonijević, Irina
Drasković, Snežana
Đorđević, Valentina
Calija, Branko
Perunicić, Jovan
Vasiljević, Zorana
Konferencijski prilog (Objavljena verzija)
Metapodaci
Prikaz svih podataka o dokumentuApstrakt
An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients. Typical death rate for HIT is about 29%, while 21% of HIT patients result in amputation of a limb. The trend towards the occurrence of HIT due to the administration of low molecular weight heparins (LMWH) taking ever conspicuous place in the standard venous thromboembolism (VTE) prophylaxis has been more frequently observed recently. It is considered that LMWH may cause HIT II in about 0.25-1%. The need for further modification of HIPA assays with LMWH has been imposed in the HIT laboratory diagnostics, heretofore overburdened with complexity. There are several constantly opposing problems arising in HIT laboratory diagnostics, one of which is that in a certain number of patients immunologic assays detect nonpath...ogenic antibodies (mainly IgM or IgA heparin-PF4 antibodies) while, on the other hand, the occurrence of HIT pathogenetically mediated by minor antigens (neutrophil-activating peptide 2 or interleukin 8) may be neglected in certain cases. The following factors play an important role in the interpretation of each laboratory HIT assays performed: 1. correlation with HIT clinical probability test, the best known of which is 4T'score, 2. the interpretation of the laboratory findings dependent on the time of the thrombocytopenia onset, as well as 3. the sensitivity and specificity of each test respectively. The HIT diagnostics in the presence of other comorbid states which may also induce thrombocytopenia, more precisely known as pseudo HIT (cancer, sepsis, disseminated intravascular coagulation, pulmonary embolism, antiphospholipid syndrome, etc), represents a specific clinical problem.
Ključne reči:
thrombocytopenia / induced / heparinIzvor:
Srpski arhiv za celokupno lekarstvo, 2010, 138, 69-73Izdavač:
- Srpsko lekarsko društvo, Beograd
DOI: 10.2298/SARH10S1069A
ISSN: 0370-8179
PubMed: 20229687
WoS: 000277366200013
Scopus: 2-s2.0-77951225482
Institucija/grupa
Institut za molekularnu genetiku i genetičko inženjerstvoTY - CONF AU - Antonijević, Nebojša AU - Radovanović, Nebojša AU - Obradović, Slobodan AU - Vucelić, Dragica AU - Stojanović, Bojan AU - Miković, Danijela AU - Kovač, Mirjana AU - Kocica, Tina AU - Tadić, Svetlana AU - Antonijević, Irina AU - Drasković, Snežana AU - Đorđević, Valentina AU - Calija, Branko AU - Perunicić, Jovan AU - Vasiljević, Zorana PY - 2010 UR - https://imagine.imgge.bg.ac.rs/handle/123456789/425 AB - An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients. Typical death rate for HIT is about 29%, while 21% of HIT patients result in amputation of a limb. The trend towards the occurrence of HIT due to the administration of low molecular weight heparins (LMWH) taking ever conspicuous place in the standard venous thromboembolism (VTE) prophylaxis has been more frequently observed recently. It is considered that LMWH may cause HIT II in about 0.25-1%. The need for further modification of HIPA assays with LMWH has been imposed in the HIT laboratory diagnostics, heretofore overburdened with complexity. There are several constantly opposing problems arising in HIT laboratory diagnostics, one of which is that in a certain number of patients immunologic assays detect nonpathogenic antibodies (mainly IgM or IgA heparin-PF4 antibodies) while, on the other hand, the occurrence of HIT pathogenetically mediated by minor antigens (neutrophil-activating peptide 2 or interleukin 8) may be neglected in certain cases. The following factors play an important role in the interpretation of each laboratory HIT assays performed: 1. correlation with HIT clinical probability test, the best known of which is 4T'score, 2. the interpretation of the laboratory findings dependent on the time of the thrombocytopenia onset, as well as 3. the sensitivity and specificity of each test respectively. The HIT diagnostics in the presence of other comorbid states which may also induce thrombocytopenia, more precisely known as pseudo HIT (cancer, sepsis, disseminated intravascular coagulation, pulmonary embolism, antiphospholipid syndrome, etc), represents a specific clinical problem. PB - Srpsko lekarsko društvo, Beograd C3 - Srpski arhiv za celokupno lekarstvo T1 - Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia EP - 73 SP - 69 VL - 138 DO - 10.2298/SARH10S1069A ER -
@conference{ author = "Antonijević, Nebojša and Radovanović, Nebojša and Obradović, Slobodan and Vucelić, Dragica and Stojanović, Bojan and Miković, Danijela and Kovač, Mirjana and Kocica, Tina and Tadić, Svetlana and Antonijević, Irina and Drasković, Snežana and Đorđević, Valentina and Calija, Branko and Perunicić, Jovan and Vasiljević, Zorana", year = "2010", abstract = "An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients. Typical death rate for HIT is about 29%, while 21% of HIT patients result in amputation of a limb. The trend towards the occurrence of HIT due to the administration of low molecular weight heparins (LMWH) taking ever conspicuous place in the standard venous thromboembolism (VTE) prophylaxis has been more frequently observed recently. It is considered that LMWH may cause HIT II in about 0.25-1%. The need for further modification of HIPA assays with LMWH has been imposed in the HIT laboratory diagnostics, heretofore overburdened with complexity. There are several constantly opposing problems arising in HIT laboratory diagnostics, one of which is that in a certain number of patients immunologic assays detect nonpathogenic antibodies (mainly IgM or IgA heparin-PF4 antibodies) while, on the other hand, the occurrence of HIT pathogenetically mediated by minor antigens (neutrophil-activating peptide 2 or interleukin 8) may be neglected in certain cases. The following factors play an important role in the interpretation of each laboratory HIT assays performed: 1. correlation with HIT clinical probability test, the best known of which is 4T'score, 2. the interpretation of the laboratory findings dependent on the time of the thrombocytopenia onset, as well as 3. the sensitivity and specificity of each test respectively. The HIT diagnostics in the presence of other comorbid states which may also induce thrombocytopenia, more precisely known as pseudo HIT (cancer, sepsis, disseminated intravascular coagulation, pulmonary embolism, antiphospholipid syndrome, etc), represents a specific clinical problem.", publisher = "Srpsko lekarsko društvo, Beograd", journal = "Srpski arhiv za celokupno lekarstvo", title = "Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia", pages = "73-69", volume = "138", doi = "10.2298/SARH10S1069A" }
Antonijević, N., Radovanović, N., Obradović, S., Vucelić, D., Stojanović, B., Miković, D., Kovač, M., Kocica, T., Tadić, S., Antonijević, I., Drasković, S., Đorđević, V., Calija, B., Perunicić, J.,& Vasiljević, Z.. (2010). Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia. in Srpski arhiv za celokupno lekarstvo Srpsko lekarsko društvo, Beograd., 138, 69-73. https://doi.org/10.2298/SARH10S1069A
Antonijević N, Radovanović N, Obradović S, Vucelić D, Stojanović B, Miković D, Kovač M, Kocica T, Tadić S, Antonijević I, Drasković S, Đorđević V, Calija B, Perunicić J, Vasiljević Z. Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia. in Srpski arhiv za celokupno lekarstvo. 2010;138:69-73. doi:10.2298/SARH10S1069A .
Antonijević, Nebojša, Radovanović, Nebojša, Obradović, Slobodan, Vucelić, Dragica, Stojanović, Bojan, Miković, Danijela, Kovač, Mirjana, Kocica, Tina, Tadić, Svetlana, Antonijević, Irina, Drasković, Snežana, Đorđević, Valentina, Calija, Branko, Perunicić, Jovan, Vasiljević, Zorana, "Obstacles in the Diagnostics and Therapy of Heparin-Induced Thrombocytopenia" in Srpski arhiv za celokupno lekarstvo, 138 (2010):69-73, https://doi.org/10.2298/SARH10S1069A . .