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Heparin-induced thrombocytopenia in paediatric patients--a review of the literature and a new case treated with danaparoid sodium.
Eur J Pediatr 1999; 158 Suppl 3:S130-3EJ

Abstract

The immunological form of heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse reaction of heparin medication. It is mediated by multimolecular complexes consisting of platelet factor 4 (PF4)-heparin-IgG which bind to platelets via platelet Fc gamma receptors. Cross-linking of multiple Fc gamma receptors results in platelet activation, platelet aggregation and enhanced thrombin generation with a increasing risk of developing new thrombosis. In children, data on HIT are sparse. This review of the literature reports on 8 children aged 3 months to 15 years and 14 newborns suffering from HIT. Additionally, we report one new case treated with danaparoid sodium. Thrombotic complications were venous (n = 12) and arterial (n = 15). The children received heparin either for a spontaneous thrombotic event, for severe cardiac diseases or to maintain patency of intravascular catheters which are used for nutrition, blood sampling, and for application of medication. After diagnosis of HIT they were further anticoagulated with aspirin, warfarin, danaparoid sodium, lepirudin or low molecular weight heparin.

CONCLUSION

Although HIT is less frequently reported in newborns and children, paediatricians should be aware of HIT in childhood as a potential complication of heparin application. The widespread practice of flushing catheters with heparin should also be debated in view of the risk of triggering the primary immune-response of HIT. In 1999, treatment options for further parenteral anticoagulation of HIT patients are danaparoid sodium (a low-molecular weight heparinoid) and lepirudin (a direct thrombin inhibitor).

Authors+Show Affiliations

Institut für Immunologie und Transfusionsmedizin, Ernst-Moritz-Arndt Universität, Greifswald, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

10650852

Citation

Ranze, O, et al. "Heparin-induced Thrombocytopenia in Paediatric Patients--a Review of the Literature and a New Case Treated With Danaparoid Sodium." European Journal of Pediatrics, vol. 158 Suppl 3, 1999, pp. S130-3.
Ranze O, Ranze P, Magnani HN, et al. Heparin-induced thrombocytopenia in paediatric patients--a review of the literature and a new case treated with danaparoid sodium. Eur J Pediatr. 1999;158 Suppl 3:S130-3.
Ranze, O., Ranze, P., Magnani, H. N., & Greinacher, A. (1999). Heparin-induced thrombocytopenia in paediatric patients--a review of the literature and a new case treated with danaparoid sodium. European Journal of Pediatrics, 158 Suppl 3, pp. S130-3.
Ranze O, et al. Heparin-induced Thrombocytopenia in Paediatric Patients--a Review of the Literature and a New Case Treated With Danaparoid Sodium. Eur J Pediatr. 1999;158 Suppl 3:S130-3. PubMed PMID: 10650852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heparin-induced thrombocytopenia in paediatric patients--a review of the literature and a new case treated with danaparoid sodium. AU - Ranze,O, AU - Ranze,P, AU - Magnani,H N, AU - Greinacher,A, PY - 2000/1/29/pubmed PY - 2000/1/29/medline PY - 2000/1/29/entrez SP - S130 EP - 3 JF - European journal of pediatrics JO - Eur. J. Pediatr. VL - 158 Suppl 3 N2 - UNLABELLED: The immunological form of heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse reaction of heparin medication. It is mediated by multimolecular complexes consisting of platelet factor 4 (PF4)-heparin-IgG which bind to platelets via platelet Fc gamma receptors. Cross-linking of multiple Fc gamma receptors results in platelet activation, platelet aggregation and enhanced thrombin generation with a increasing risk of developing new thrombosis. In children, data on HIT are sparse. This review of the literature reports on 8 children aged 3 months to 15 years and 14 newborns suffering from HIT. Additionally, we report one new case treated with danaparoid sodium. Thrombotic complications were venous (n = 12) and arterial (n = 15). The children received heparin either for a spontaneous thrombotic event, for severe cardiac diseases or to maintain patency of intravascular catheters which are used for nutrition, blood sampling, and for application of medication. After diagnosis of HIT they were further anticoagulated with aspirin, warfarin, danaparoid sodium, lepirudin or low molecular weight heparin. CONCLUSION: Although HIT is less frequently reported in newborns and children, paediatricians should be aware of HIT in childhood as a potential complication of heparin application. The widespread practice of flushing catheters with heparin should also be debated in view of the risk of triggering the primary immune-response of HIT. In 1999, treatment options for further parenteral anticoagulation of HIT patients are danaparoid sodium (a low-molecular weight heparinoid) and lepirudin (a direct thrombin inhibitor). SN - 0340-6199 UR - https://www.unboundmedicine.com/medline/citation/10650852/Heparin_induced_thrombocytopenia_in_paediatric_patients__a_review_of_the_literature_and_a_new_case_treated_with_danaparoid_sodium_ L2 - https://dx.doi.org/10.1007/pl00014338 DB - PRIME DP - Unbound Medicine ER -