Ribal J P, Glanddier G, Gilbert M
J Chir (Paris). 1985 Jun-Jul;122(6-7):375-7.
Four new cases of the white thrombus syndrome have been treated over the last 3 years. This is a rare but serious complication of heparin therapy, multifocal arterial thrombi developing in all three patients without signs of a hemorrhagic syndrome due to the thrombopenia. Physiopathologic mechanisms of this immunity phenomenon are discussed. The diagnosis should be evoked in all patients receiving heparin who on about the 10th day present vascular manifestations of the thrombosis type, rarely in association with a hemorrhage. Blood platelet levels are reduced to below 5000/mm3. Confirmation of diagnosis is by positive results of hematologic and immunologic tests. Treatment involves immediate cessation of heparin and administration of anti-platelet aggregation agents and anti-vitamins K or low molecular weight heparin, combined with arterial thrombectomy or prevention of pulmonary emboli.
在过去3年里共治疗了4例白色血栓综合征新病例。这是肝素治疗罕见但严重的并发症，所有3例患者均出现多灶性动脉血栓形成，且无因血小板减少导致的出血综合征迹象。本文讨论了这种免疫现象的生理病理机制。对于所有接受肝素治疗且在大约第10天出现血栓形成类型血管表现（很少伴有出血）的患者，均应考虑该诊断。血小板水平降至5000/mm³以下。通过血液学和免疫学检查结果阳性来确诊。治疗包括立即停用肝素，给予抗血小板聚集剂和维生素K拮抗剂或低分子量肝素，并结合动脉血栓切除术或预防肺栓塞。
