|
|
Prepublished online as a Blood First Edition Paper on December 27, 2002; DOI 10.1182/blood-2002-05-1448.
Submitted May 16, 2002
Accepted December 5, 2002
Central venous catheters and upper-extremity deep-vein thrombosis complicating immune heparin-induced thrombocytopenia
Aaron P Hong, Deborah J Cook, Christopher S Sigouin, and Theodore E Warkentin*
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, ON, Canada
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Department of Anaesthesia, McMaster University, Hamilton, ON, Canada
Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
* Corresponding author; email: twarken{at}mcmaster.ca.
Heparin-induced thrombocytopenia (HIT) is a transient antibody-mediated hypercoagulability state strongly associated with lower-limb deep-vein thrombosis (DVT). Whether HIT is additionally associated with upper-limb DVT--either with or without central venous catheter (CVC) use--is unknown. We therefore studied 260 patients with antibody-positive HIT to determine the influence of CVC use on frequency and localization of upper-extremity DVT, in comparison with two non-HIT control populations (postoperative orthopedic surgery and intensive-care unit patients). Compared with the control populations, both upper- and lower-extremity DVTs were found to be associated with HIT. Upper-extremity DVTs occurred more frequently in HIT patients with a CVC (14 of 145 [9.7%]) versus none of 115 (0%) patients without a CVC (p=0.00035). All upper-extremity DVTs occurred at the CVC site (right, 12; left, 2; kappa=1.0; p=0.011). We conclude that a localizing vascular injury (CVC use) and a systemic hypercoagulability disorder (HIT) interact to explain upper-extremity DVT complicating HIT.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
J. G. Kelton and T. E. Warkentin
Heparin-induced thrombocytopenia: a historical perspective
Blood,
October 1, 2008;
112(7):
2607 - 2616.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. P. Mullen, D. L. Wessel, K. C. Thomas, K. Gauvreau, E. J. Neufeld, F. X. McGowan Jr, and J. A. DiNardo
The Incidence and Implications of Anti-Heparin-Platelet Factor 4 Antibody Formation in a Pediatric Cardiac Surgical Population
Anesth. Analg.,
August 1, 2008;
107(2):
371 - 378.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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]
|
|
|
|
|
|
|
I. Apostolidou, M. F. Sweeney, E. Missov, L. D. Joyce, R. John, and R. C. Prielipp
Acute Left Atrial Thrombus After Recombinant Factor VIIa Administration During Left Ventricular Assist Device Implantation in a Patient with Heparin-Induced Thrombocytopenia
Anesth. Analg.,
February 1, 2008;
106(2):
404 - 408.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Levy, K. A. Tanaka, and M. J. Hursting
Reducing Thrombotic Complications in the Perioperative Setting: An Update on Heparin-Induced Thrombocytopenia
Anesth. Analg.,
September 1, 2007;
105(3):
570 - 582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Warkentin and M. A. Crowther
When is HIT Really HIT?
Ann. Thorac. Surg.,
January 1, 2007;
83(1):
21 - 23.
[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]
|
|
|
|
|
|
|
D. Kejariwal
Heparin-induced thrombocytopenia: A COMPLICATION OF THROMBOPROPHYLAXIS
J Bone Joint Surg Br,
March 1, 2006;
88-B(3):
392 - 393.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I.-K. Jang and M. J. Hursting
When Heparins Promote Thrombosis: Review of Heparin-Induced Thrombocytopenia
Circulation,
May 24, 2005;
111(20):
2671 - 2683.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Warkentin
New Approaches to the Diagnosis of Heparin-Induced Thrombocytopenia
Chest,
February 1, 2005;
127(2_suppl):
35S - 45S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. T. Gurbuz, W. G. Elliott, and A. A. Zia
Heparin-induced thrombocytopenia in the cardiovascular patient: diagnostic and treatment guidelines
Eur. J. Cardiothorac. Surg.,
January 1, 2005;
27(1):
138 - 149.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Warkentin and A. Greinacher
Heparin-Induced Thrombocytopenia: Recognition, Treatment, and Prevention: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy
Chest,
September 1, 2004;
126(3_suppl):
311S - 337S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Risch and A. R. Huber
Improving the Definition of Heparin-Induced Thrombocytopenia
Arch Intern Med,
August 9, 2004;
164(15):
1699 - 1699.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Cines, J. B. Bussel, R. B. McMillan, and J. L. Zehnder
Congenital and Acquired Thrombocytopenia
Hematology,
January 1, 2004;
2004(1):
390 - 406.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Warkentin, W. C. Aird, and J. H. Rand
Platelet-Endothelial Interactions: Sepsis, HIT, and Antiphospholipid Syndrome
Hematology,
January 1, 2003;
2003(1):
497 - 519.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
