Utility of thrombocytopenia as a marker for heparin allergy in adult ED patients

The American Journal of Emergency Medicine
Matthew D Howell, Robert D Powers

Abstract

Up to 5% of patients who receive heparin develop heparin allergy (HA), manifested by the presence of heparin antibodies (HAb) and/or the clinical syndrome of heparin-induced thrombocytopenia. As many as 10% of patients with HA develop serious thrombotic complications when reexposed to heparin. Heparin is often given empirically to emergency department (ED) patients, some of whom have been recently hospitalized and are at risk for HA/heparin-induced thrombocytopenia. Emergency department physicians should have a rapid means of determining which patients are at risk for heparin sensitivity. The prevalence of HA among ED patients is unknown; most are asymptomatic and unaware, and there is no bedside test available. This study was designed to assess the prevalence of HA or thrombocytopenia in ED patients and to determine whether thrombocytopenia could serve as a useful marker for HA. This was a prospective, observational study, done during the spring of 2004 in an 80000 adult visit inner-city ED. A convenience sample of 115 adult patients undergoing venipuncture had a blood specimen analyzed for platelet count using standard laboratory methods. The same blood sample was tested for the presence of antiheparin antibodies using an enz...Continue Reading

References

May 25, 2004·Intensive Care Medicine·Jos P J WesterGerda Veth

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Citations

Mar 14, 2007·The American Journal of Emergency Medicine·John L FrancisRobert L Levine
Jun 22, 2006·The American Journal of Emergency Medicine·Joanne G KuntzRobert D Powers
Jun 5, 2010·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Robert L LevineMarcie J Hursting
May 13, 2014·Clinical Chemistry and Laboratory Medicine : CCLM·Fabrizio TurvaniEnrico Lupia

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