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Blood, 1 November 2005, Vol. 106, No. 9, pp. 3049-3054. Prepublished online as a Blood First Edition Paper on July 19, 2005; DOI 10.1182/blood-2005-03-0912. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-03-0912v1 106/9/3049    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Prandoni, P. Articles by Fabris, F. Search for Related Content PubMed PubMed Citation Articles by Prandoni, P. Articles by Fabris, F. Related Collections Hematopoiesis and Stem Cells Hemostasis, Thrombosis, and Vascular Biology Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY The incidence of heparin-induced thrombocytopenia in medical patients treated with low-molecular-weight heparin: a prospective cohort study Paolo Prandoni, Sergio Siragusa, Bruno Girolami, Fabrizio Fabris, for the BELZONI Investigators Group From the Scienze Mediche e Chirurgiche, Clinica Medica II, Università di Padova, Padova, Italy; Malattie Tromboemboliche ed Emorragiche, Ematologia con Trapianto, Azienda Ospedaliera Universitaria di Palermo, Palermo, Italy; Medicina Generale, Azienda Ospedaliera di Padova, Padova, Italy; Scienze Mediche e Chirurgiche, Medicina Interna, Università di Padova, Padova, Italy. In contrast with extensive documentation in patients treated with unfractionated heparin (UFH), the incidence of heparin-induced thrombocytopenia (HIT) in medical patients receiving low-molecular-weight heparin (LMWH) is less well defined. In a prospective cohort study, the platelet count was monitored in 1754 consecutive patients referred to 17 medical centers and treated with LMWH for prophylaxis or treatment of thromboembolic disorders. The diagnosis of HIT was accepted in case of a platelet drop of at least 50%, the absence of obvious explanations for thrombocytopenia, and the demonstration of heparin-dependent IgG antibodies. HIT developed in 14 patients (0.80%; 95% CI, 0.43%-1.34%), in all of them within the first 2 weeks, and was more frequent in patients who had (1.7%) than in those who had not (0.3%) been exposed to UFH or LMWH (OR = 4.9; 95% CI, 1.5-15.7). The prevalence of thromboembolic complications in HIT patients (4 of 14; 28.6%) was remarkably higher than that (41 of 1740; 2.4%) observed in the remaining patients (OR = 16.6; 95% CI, 5.0-55.0). Immune thrombocytopenia and related thromboembolism may complicate the clinical course of medical patients treated with LMWH with a frequency that is not different from that observed with the use of UFH. The previous administration of heparin increases the rate of HIT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Unfractionated LMWH and the risk of HIT: are medical patients different? Theodore E. Warkentin and Andreas Greinacher Blood 2005 106: 2931-2932. [Full Text] [PDF] This article has been cited by other articles: T. E. Warkentin, A. Greinacher, A. Koster, and A. M. Lincoff Treatment and Prevention of Heparin-Induced Thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 340S - 380S. [Abstract] [Full Text] [PDF] G. B. F. Oliveira, E. M. Crespo, R. C. Becker, E. F. Honeycutt, C. S. Abrams, K. J. Anstrom, P. B. Berger, L. D. Davidson-Ray, E. L. Eisenstein, N. S. Kleiman, et al. Incidence and Prognostic Significance of Thrombocytopenia in Patients Treated With Prolonged Heparin Therapy Arch Intern Med, January 14, 2008; 168(1): 94 - 102. [Abstract] [Full Text] [PDF] M. Demir, E. Duran, O. Yigitbasi, O. Vural, T. Kurum, M. Yuksel, B. Turgut, J. M. Walenga, and J. Fareed Incidence of Antiheparin-Platelet Factor 4 Antibodies and Heparin-Induced Thrombocytopenia in Turkish Patients Undergoing Cardiac Surgery Clinical and Applied Thrombosis/Hemostasis, July 1, 2007; 13(3): 279 - 284. [Abstract] [PDF] M. A. Smythe, J. M. Koerber, and J. C. Mattson The Incidence of Recognized Heparin-Induced Thrombocytopenia in a Large, Tertiary Care Teaching Hospital Chest, June 1, 2007; 131(6): 1644 - 1649. [Abstract] [Full Text] [PDF] S. Siragusa, A. Malato, F. Falaschi, F. Porro, R. Anastasio, A. Giarratano, L. L. Coco, M. C. Buonanno, E. Maggi, M. A. Bressan, et al. Deferral of assessment of pulmonary embolism Haematologica, March 1, 2007; 92(3): 410 - 413. [Abstract] [Full Text] [PDF] D. W. Harrington and A. Jindeel Fixed-Dose Unfractionated Heparin vs Low-Molecular-Weight Heparin for Venous Thromboembolism JAMA, January 17, 2007; 297(3): 262 - 262. [Full Text] [PDF] T. E. Warkentin, J.-A. I. Sheppard, C. S. Sigouin, T. Kohlmann, P. Eichler, and A. Greinacher Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia Blood, November 1, 2006; 108(9): 2937 - 2941. [Abstract] [Full Text] [PDF] G. M. Arepally and T. L. Ortel Heparin-Induced Thrombocytopenia N. Engl. J. Med., August 24, 2006; 355(8): 809 - 817. [Full Text] [PDF] P. Prandoni How I treat venous thromboembolism in patients with cancer Blood, December 15, 2005; 106(13): 4027 - 4033. [Abstract] [Full Text] [PDF]

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