Perspective Heparin therapy for disseminated intravascular coagulation

1972 ◽  
Vol 264 (5) ◽  
pp. 365-366 ◽  
Author(s):  
AARON J. MARCUS
1971 ◽  
Vol 17 (12) ◽  
pp. 1216-1216 ◽  
Author(s):  
Lowell B Foster ◽  
Christopher S Frings ◽  
Jane M Hochholzer

Author(s):  
Anne-Mette Hvas ◽  
Erik L Grove ◽  
Steen Dalby Kristensen

Coagulation is evaluated by conventional coagulation analyses, often supplemented by point-of-care tests. Recently, a number of point-of-care tests for evaluation of platelet function and the efficacy of antiplatelet therapy has been investigated. Thrombophilia contributes to the risk of thrombosis, and a battery of complex assays is required to identify all thrombophilias. Disseminated intravascular coagulation is characterized by microthrombosis and clinical bleeding. A scoring system for overt disseminated intravascular coagulation provides a five-step diagnostic algorithm. The cornerstone of the management of disseminated intravascular coagulation is treatment of the underlying triggering condition. Heparin-induced thrombocytopenia is an adverse immunological effect of heparin therapy. Besides thrombocytopenia, the major clinical consequence of heparin-induced thrombocytopenia is an increased risk of thrombosis. The diagnosis is based on clinical symptoms and detection of platelet-activating heparin-induced thrombocytopenia antibodies. When heparin-induced thrombocytopenia is strongly suspected, it is recommended to stop heparin treatment, investigate for heparin-induced thrombocytopenia antibodies, and initiate non-heparin anticoagulant treatment.


PEDIATRICS ◽  
1971 ◽  
Vol 48 (3) ◽  
pp. 491-492
Author(s):  
Peter Johan Moe ◽  
David C. Mauger

Will you please permit a short comment on the article: "Letterer-Siwe's Disease (Acute Disseminated Histiocytosis X). A Case Complicated by Disseminated Intravascular Coagulation and Responding to Heparin Therapy" by Dr. Mauger?1 In this article David C. Mauger gives an interesting presentation of a 17-month-old female with Letterer-Siwe's disease with skin hemorrhage and thrombocytopenia in conjunction with disseminated intravascular coagulation. It is stated in the article that disseminated intravascular coagulation has not been described in Letterer-Siwe's disease.


PEDIATRICS ◽  
1971 ◽  
Vol 47 (2) ◽  
pp. 435-437
Author(s):  
David C. Mauger

Hemorrhagic skin lesions and thrombocytopenia are common manifestations of Letterer-Siwe disease.1-9 Both have been considered to be indicative of a grave prognosis.7,8 The case reported here satisfies the clinical criteria of Abt and Denenholz1 and the pathological criteria of Oberman.5 She presented with a hemorrhagic skin rash, thrombocytopenia, and a clotting profile indicative of intravascular coagulation. These abnormalities appeared to respond quickly to heparin and she is currently surviving some 8 months later, further improvement having been achieved by the administration of prednisone and cyclophosphamide. Disseminated intravascular coagulation is now known to be a feature of many diseases, but it has not previously been described in this disorder and may well contribute to the poor prognosis which has been associated with the onset of hemorrhagic manifestations.


Author(s):  
Anne-Mette Hvas ◽  
Erik L Grove ◽  
Steen Dalby Kristensen

Coagulation is evaluated by conventional coagulation analyses, often supplemented by point-of-care tests. Recently, a number of point-of-care tests for evaluation of platelet function and the efficacy of antiplatelet therapy has been investigated. Thrombophilia contributes to the risk of thrombosis, and a battery of complex assays is required to identify all thrombophilias. Disseminated intravascular coagulation is characterized by microthrombosis and clinical bleeding. A scoring system for overt disseminated intravascular coagulation provides a five-step diagnostic algorithm. The cornerstone of the management of disseminated intravascular coagulation is treatment of the underlying triggering condition. Heparin-induced thrombocytopenia is an adverse immunological effect of heparin therapy. Besides thrombocytopenia, the major clinical consequence of heparin-induced thrombocytopenia is an increased risk of thrombosis. The diagnosis is based on clinical symptoms and detection of platelet-activating heparin-induced thrombocytopenia antibodies. When heparin-induced thrombocytopenia is strongly suspected, it is recommended to stop heparin treatment, investigate for heparin-induced thrombocytopenia antibodies, and initiate non-heparin anticoagulant treatment.


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