Hill G R, Hickton C, Henderson S, Patton W N
Department of Haematology, Christchurch Hospital, New Zealand.
Clin Lab Haematol. 1997 Jun;19(2):155-7. doi: 10.1046/j.1365-2257.1997.00052.x.
We report a case of heparin-induced thrombocytopenia with in vitro antibody cross-reactivity by platelet aggregometry to both low molecular weight heparin and the heparinoid Org 10172 (Orgaran). The in vitro reactivity with Orgaran was only present at the upper limit of concentrations that would normally be used therapeutically. Low dose Orgaran therapy was initiated, allowing successful renal replacement therapy without invoking further thrombocytopenia or thrombosis. Interestingly, in vitro platelet aggregometry following treatment did not reveal increasing sensitivity to Orgaran. This case indicates that negative in vitro platelet aggregometry at defined lower concentrations of Orgaran may predict in vivo safety at the same levels despite positive platelet aggregometry reactions at higher concentrations of Orgaran.
我们报告一例肝素诱导的血小板减少症，通过血小板聚集试验检测发现其体外抗体与低分子量肝素和类肝素药物Org 10172（奥加诺）存在交叉反应。与奥加诺的体外反应仅出现在通常用于治疗的浓度上限。开始低剂量奥加诺治疗后，成功进行了肾脏替代治疗，未引发进一步的血小板减少或血栓形成。有趣的是，治疗后的体外血小板聚集试验未显示对奥加诺的敏感性增加。该病例表明，尽管在较高浓度的奥加诺时血小板聚集试验呈阳性反应，但在规定的较低浓度奥加诺时体外血小板聚集试验呈阴性可能预示着相同水平的体内安全性。
