High-dose intravenous γ-globulins for heparin-induced thrombocytopenia:: A prompt response

被引:33
作者
Winder, A
Shoenfeld, Y [1 ]
Hochman, R
Keren, G
Levy, Y
Eldor, A
机构
[1] Tel Aviv Univ, Dept Med B, Autoimmune Dis Res Unit, Sheba Med Ctr, IL-69978 Tel Aviv, Israel
[2] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
[3] Tel Aviv Sourasky Med Ctr, Inst Hematol, Tel Aviv, Israel
[4] Tel Aviv Sourasky Med Ctr, Dept Med, Tel Aviv, Israel
[5] Tel Aviv Sourasky Med Ctr, Dept Cardiol, Tel Aviv, Israel
关键词
thrombocytopenia; heparin; IVIG; autoimmunity; autoantibodies;
D O I
10.1023/A:1023238915316
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Heparin-induced thrombocytopenia (HIT) is a common drug induced autoimmune condition. The thrombocytopenia is caused in most cases by an antibody directed against the complex PF4/heparin. Recently, we have induced an experimental model of HIT by idiotypic manipulation. To confirm further the idiotypic involvement of HIT, we have treated successfully three patients with HIT with high-dose intravenous gamma-globulin (IVIG). Our three patients join other two cases previously reported who were treated with IVIG and point to the efficacy of this type of therapy with minimal side effects. IVIG suppression of the anti-PF4/heparin autoantibody may support the idiotypic etiology of HIT.
引用
收藏
页码:330 / 334
页数:5
相关论文
共 28 条
[1]  
ADELMAN B, 1989, J LAB CLIN MED, V113, P204
[2]  
AMIRAL J, 1992, THROMB HAEMOSTASIS, V68, P95
[3]   Presence of autoantibodies to interleukin-8 or neutrophil-activating peptide-2 in patients with heparin-associated thrombocytopenia [J].
Amiral, J ;
MarfaingKoka, A ;
Wolf, M ;
Alessi, MC ;
Tardy, B ;
BoyerNeumann, C ;
Vissac, AM ;
Fressinaud, E ;
Poncz, M ;
Meyer, D .
BLOOD, 1996, 88 (02) :410-416
[4]   INSIGHTS INTO HEPARIN-INDUCED THROMBOCYTOPENIA [J].
ANDERSON, GP .
BRITISH JOURNAL OF HAEMATOLOGY, 1992, 80 (04) :504-508
[5]   Pathogenicity of human anti-platelet factor 4 (PF4)/heparin in vivo: Generation of mouse anti-PF4/heparin and induction of thrombocytopenia by heparin [J].
Blank, M ;
Cines, DB ;
Arepally, G ;
Eldor, A ;
Afek, A ;
Shoenfeld, Y .
CLINICAL AND EXPERIMENTAL IMMUNOLOGY, 1997, 108 (02) :333-339
[6]   HEPARIN-INDUCED THROMBOCYTOPENIA - EFFECTS OF RABBIT IGG, AND ITS FAB AND FC FRAGMENTS ON ANTIBODY-HEPARIN-PLATELET INTERACTION [J].
CHONG, BH ;
CASTALDI, PA ;
BERNDT, MC .
THROMBOSIS RESEARCH, 1989, 55 (02) :291-295
[7]  
CHONG BH, 1993, THROMB HAEMOSTASIS, V69, P344
[8]  
CHONG BH, 1993, BLOOD, V81, P988
[9]   HEPARIN-INDUCED THROMBOCYTOPENIA - MECHANISM OF INTERACTION OF THE HEPARIN-DEPENDENT ANTIBODY WITH PLATELETS [J].
CHONG, BH ;
FAWAZ, I ;
CHESTERMAN, CN ;
BERNDT, MC .
BRITISH JOURNAL OF HAEMATOLOGY, 1989, 73 (02) :235-240
[10]   ANNOTATION - HEPARIN-INDUCED THROMBOCYTOPENIA [J].
CHONG, BH .
BRITISH JOURNAL OF HAEMATOLOGY, 1995, 89 (03) :431-439