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Low prevalence of heparin-induced thrombocytopenia after cardiac surgery in Thai patients.
[heparin-induced thrombocytopenia]
Heparin
induced-
thrombocytopenia
(
HIT
)
has
been
well
recognized
in
Western
countries
.
However
,
there
are
no
data
in
the
Thai
population
.
We
therefore
investigated
the
prevalence
of
anti-
platelet
factor
4
(
PF
4
)
/
heparin
antibodies
,
HIT
,
and
its
thrombotic
complications
in
Thai
patients
undergoing
cardiac
surgery
using
unfractionated
heparin
.
Seventy
-
three
consecutive
patients
were
prospectively
enrolled
in
this
study
.
Blood
samples
before
operation
and
week
1
,
week
2
,
and
week
3
after
operation
were
collected
from
each
patient
for
HIT
antibody
screening
by
enzyme-linked
immunosorbent
assay
using
IgG
antibody
specific
to
the
PF
4
/
heparin
complex
.
Positive
samples
were
further
analyzed
by
(
14
)
C-
serotonin
release
assay
.
Complete
blood
count
was
performed
daily
during
the
first
week
,
then
weekly
for
3
weeks
.
No
patient
had
detectable
anti-
PF
4
/
heparin
antibodies
at
baseline
.
Five
patients
sero-converted
during
the
course
of
the
study
for
anti-
PF
4
/
heparin
IgG
:
3
(
4
.
1
%
)
at
week
1
,
4
(
5
.
5
%
)
at
week
2
,
and
5
(
6
.
8
%
)
at
week
3
after
surgery
.
However
,
none
of
these
patients
had
anti-
PF
4
/
heparin
antibodies
that
resulted
in
(
14
)
C-
serotonin
release
to
be
considered
clinically
significant
antibodies
.
Post-operative
thrombocytopenia
after
the
operation
was
found
in
35
patients
(
47
.
9
%
)
,
but
was
not
considered
to
be
caused
by
HIT
.
Thromboembolic
events
occurred
in
3
patients
(
4
.
1
%
)
during
follow
up
;
however
,
none
of
these
patients
had
positive
PF
4
/
heparin
antibody
tests
.
Our
study
represents
the
first
study
to
examine
Thai
patients
exposed
to
heparin
in
the
context
of
cardiac
surgery
.
We
found
a
lower
prevalence
of
positive
anti-
PF
4
/
heparin
antibodies
and
clinical
HIT
than
previously
published
studies
.
Diseases
Validation
Diseases presenting
"first study"
symptom
achondroplasia
acute rheumatic fever
alexander disease
aniridia
coats disease
congenital adrenal hyperplasia
cowden syndrome
dystrophic epidermolysis bullosa
erythropoietic protoporphyria
familial hypocalciuric hypercalcemia
familial mediterranean fever
heparin-induced thrombocytopenia
hirschsprung disease
krabbe disease
locked-in syndrome
oculocutaneous albinism
primary effusion lymphoma
waldenström macroglobulinemia
wiskott-aldrich syndrome
zellweger syndrome
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