Keng T B, Chong B H
Department of Haematology, Prince of Wales Hospital, Randwick, Australia.
Br J Haematol. 2001 Aug;114(2):394-6. doi: 10.1046/j.1365-2141.2001.02943.x.
Heparin-induced thrombocytopenia and thrombosis syndrome (HITTS) is an immune-mediated drug reaction that occurs 5-14 d after initiation of heparin therapy and is a potentially life-threatening thrombotic complication. The antibody-heparin-PF4 complexes cause platelet activation and generation of platelet microparticles. The need for anticoagulant treatment in asymptomatic thrombocytopenia is uncertain. However, treatment is warranted in HITTS, as illustrated in the case reported here. Danaparoid, r-Hirudin and argatroban are effective drugs. Danaparoid has a 10-50% in vitro cross-reactivity rate with the HIT antibodies, but has been proven to be clinically efficacious even in these cases. Here, we report a case of in vivo cross-reactivity with danaparoid, the patient showed an excellent recovery with r-Hirudin.
肝素诱导的血小板减少症和血栓形成综合征（HITTS）是一种免疫介导的药物反应，发生在肝素治疗开始后的5 - 14天，是一种潜在的危及生命的血栓并发症。抗体 - 肝素 - PF4复合物导致血小板活化和血小板微粒的生成。无症状性血小板减少症是否需要抗凝治疗尚不确定。然而，正如本文报道的病例所示，HITTS需要进行治疗。达那肝素、重组水蛭素和阿加曲班是有效的药物。达那肝素与HIT抗体的体外交叉反应率为10 - 50%，但已被证明即使在这些病例中临床疗效也很好。在此，我们报告一例达那肝素体内交叉反应的病例，该患者使用重组水蛭素后恢复良好。
