Plasmapheresis : a therapeutic option in the management of heparin-associated thrombocytopenia with thrombosis

Heparin-associated thrombocytopenia with thrombosis (HATT) is an uncommon syndrome that is estimated to occur in 1-5% of patients with heparin-induced thrombocytopenia. Early diagnosis requires careful clinical surveillance, and the management of these patients can be complex. Cessation of heparin t...

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Bibliographic Details
Published inAmerican journal of clinical pathology Vol. 96; no. 3; pp. 394 - 397
Main Authors BRADY, J, RICCIO, J. A, YUMEN, O. H, MAKARY, A. Z, GREENWOOD, S. M
Format Journal Article
LanguageEnglish
Published Chicago, IL American Society of Clinical Pathologists 01.09.1991
Subjects
Biological and medical sciences
Hematologic and hematopoietic diseases
Heparin - adverse effects
Humans
In Vitro Techniques
Male
Medical sciences
Middle Aged
Plasmapheresis
Platelet Aggregation
Thrombocytopenia - chemically induced
Thrombocytopenia - complications
Thrombocytopenia - therapy
Thrombosis - complications
Case study
Human
Thrombocythemia
Treatment
Hemopathy
Heparin
Thrombosis
Plasmapheresis
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Summary:Heparin-associated thrombocytopenia with thrombosis (HATT) is an uncommon syndrome that is estimated to occur in 1-5% of patients with heparin-induced thrombocytopenia. Early diagnosis requires careful clinical surveillance, and the management of these patients can be complex. Cessation of heparin therapy and substitution or addition of oral anticoagulants, antiplatelet agents, dextrans, and prostacyclin analogues have been advocated. The authors are aware of only two case reports in the literature that examine the use of plasmapheresis as a therapeutic alternative. The authors report a case of a 53-year-old white man who developed HATT after a single protamine-reversed exposure to heparin. Controlled platelet aggregation studies performed before and after apheresis sessions documented a dramatic response and rapid normalization of platelet number and function in the patient. The authors conclude that plasmapheresis could be a valuable adjunct in the successful management of patients with HATT. When done in conjunction with platelet aggregation studies, an objective measurement of therapeutic efficacy can be achieved.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/96.3.394