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Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases.

hal.structure.identifierGroupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque [GRT]
dc.contributor.authorTARDY-PONCET, B.
hal.structure.identifierInstitute of Neuropathology
dc.contributor.authorWOLF, M.
hal.structure.identifierCentre de physique moléculaire optique et hertzienne [CPMOH]
dc.contributor.authorLASNE, D.
dc.contributor.authorBAUTERS, A.
dc.contributor.authorFFRENCH, P.
hal.structure.identifierSignalisation cellulaire, dynamique circulatoire et athérosclérose précoce [SCDCAP]
dc.contributor.authorELALAMY, I.
hal.structure.identifierGroupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque [GRT]
dc.contributor.authorTARDY, B.
dc.date.issued2009-08
dc.description.abstractEnPURPOSE: Danaparoid is a safe and effective drug for the treatment of heparin-induced thrombocytopenia (HIT). We describe an uncommon complication: danaparoid cross-reactivity with HIT antibodies. DESIGN AND SETTING: A retrospective observational multicenter study on HIT was conducted in France. In this study concerning HIT patients treated with lepirudin, 12 patients were treated with lepirudin because danaparoid cross-reacted with the heparin-dependent antibodies. RESULTS: Three groups of situations can be separated. In a first group, four patients received a short course of danaparoid until their initial functional HIT assay showed a cross-reactivity between danaparoid and HIT antibodies. One patient presented a fatal thrombotic complication but the relationship between this thrombotic complication and danaparoid cross-reactivity cannot be certain. In a second group, four patients received for 4 days at least a danaparoid treatment while the initial functional test did not show any danaparoid cross-reactivity. During danaparoid treatment, no significant increase of platelet count was observed and two patients presented a fatal thrombotic complication. In a third group, cross-reactivity between danaparoid and HIT antibodies was not checked before danaparoid therapy. During danaparoid treatment, no significant increase of platelet count was observed and the four patients developed a venous thromboembolic complication. CONCLUSION: Absence of any increase in platelet count after 3 to 5 days of danaparoid therapy and/or the occurrence of a new thrombotic event should lead to danaparoid cross-reactivity suspicion. However, before attributing thrombotic complications to danaparoid cross-reactivity, it is crucial to verify that the patients received the recommended danaparoid dosage regimen.
dc.language.isoen
dc.subject.meshAged
dc.subject.meshAnticoagulants
dc.subject.meshHumans
dc.subject.meshIntensive Care Units
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPurpura, Thrombocytopenic, Idiopathic
dc.subject.meshRecombinant Proteins
dc.subject.meshRetrospective Studies
dc.subject.meshChondroitin Sulfates
dc.subject.meshCross Reactions
dc.subject.meshDermatan Sulfate
dc.subject.meshFemale
dc.subject.meshHemostasis
dc.subject.meshHeparin
dc.subject.meshHeparitin Sulfate
dc.subject.meshHirudins
dc.title.enDanaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases.
dc.typeArticle de revue
dc.identifier.doi10.1007/s00134-009-1464-x
dc.subject.halSciences du Vivant [q-bio]/Sciences pharmaceutiques/Pharmacologie
bordeaux.journalIntensive Care Med
bordeaux.page1449-53
bordeaux.volume35
bordeaux.issue8
bordeaux.peerReviewedoui
hal.identifierujm-00440308
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//ujm-00440308v1
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