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Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia TE Warkentin, CP Hayward, LK Boshkov, AV Santos, JA Sheppard, AP Bode and JG Kelton Department of Laboratory Medicine, Hamilton Civic Hospitals (General Division), Ontario, Canada. Heparin-induced thrombocytopenia is characterized by moderate thrombocytopenia and thrombotic complications, whereas quinine/quinidine-induced thrombocytopenia usually presents with severe thrombocytopenia and bleeding. Using flow cytometry and assays of procoagulant activity, we investigated whether sera from patients with these immune drug reactions could stimulate normal platelets to generate platelet-derived microparticles with procoagulant activity. Sera or purified IgG from patients with heparin-induced thrombocytopenia stimulated the formation of platelet-derived microparticles in a heparin-dependent fashion. Further studies showed that heparin-induced thrombocytopenia sera also produced a marked increase in procoagulant activity. In contrast, sera from patients with quinine- or quinidine-induced thrombocytopenia did not generate platelet-derived microparticles nor generate increased procoagulant activity. However, quinine/quinidine-induced thrombocytopenia sera produced a significant increase in the binding of IgG to platelets in a drug-dependent fashion, whereas sera from patients with heparin-induced thrombocytopenia demonstrated no drug-dependent binding of IgG to platelets. We also observed increased levels of circulating microparticles in patients with acute heparin-induced thrombocytopenia compared with control patients. Our observations indicate that the generation of procoagulant platelet-derived microparticles in vivo is a plausible explanation for the thrombotic complications observed in some patients with heparin-induced thrombocytopenia. Volume 84, Issue 11, pp. 3691-3699, 12/01/1994 Copyright © 1994 by The American Society of Hematology CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. C. Vedder, E. Biro, J. M. F. G. Aerts, R. Nieuwland, G. Sturk, and C. E. M. Hollak Plasma markers of coagulation and endothelial activation in Fabry disease: impact of renal impairment Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3074 - 3081. [Abstract] [Full Text] [PDF] T. E. Warkentin, J.-A. I. Sheppard, J. C. Moore, R. J. Cook, and J. G. Kelton Studies of the immune response in heparin-induced thrombocytopenia Blood, May 14, 2009; 113(20): 4963 - 4969. [Abstract] [Full Text] [PDF] K. A. Tanaka, N. S. Key, and J. H. 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