Related Experiment Videos
Danaparoid sodium (Orgaran) in four children with heparin-induced thrombocytopenia type II
B Zöhrer'1, W Zenz, A Rettenbacher
1Department of Paediatrics, Karl Franzens University of Graz, Austria.
Insights
Heparin-induced thrombocytopenia type II is a serious condition in children. Danaparoid sodium effectively halted disease progression in all patients, leading to recovery in most.
Area of Science:
- Pediatric Hematology
- Thrombosis and Hemostasis
Background:
- Heparin-induced thrombocytopenia type II (HIT II) is a rare but severe immune-mediated complication of heparin therapy.
- HIT II can lead to life-threatening thrombotic events.
Observation:
- Four pediatric patients with HIT II were identified.
- Three patients experienced severe thrombotic complications including cardiac thrombi, inferior vena cava thrombosis, and peripheral arterial occlusion.
- One patient diagnosed early showed no complications.
Findings:
- All patients tested positive for heparin-induced platelet activation and/or heparin/platelet factor 4-ELISA.
- Elevated antiphospholipid antibodies were present in all cases.
- Danaparoid sodium administration, at doses ranging from 1.2 to 7.1 U/kg/h, successfully arrested disease progression in all four children.
Implications:
- HIT II poses a significant life-threatening risk in pediatric patients.
- Danaparoid sodium demonstrates therapeutic benefit in managing HIT II in children.
- Early diagnosis and prompt treatment are crucial for favorable outcomes, though severe complications like limb amputation may still occur.
Unlabelled:
We report on four children with heparin-induced thrombocytopenia type II. In three patients, therapy with unfractionated heparin was associated with development of cardiac thrombi or with thrombosis progression up to the inferior vena cava or with aggravation of peripheral arterial occlusion. In the fourth child, the disease was recognized early on, and no complication occurred. Heparin-induced thrombocytopenia type II was confirmed by heparin-induced platelet activation assay and/or heparin/platelet factor 4-ELISA. Concomitant elevated antiphospholipid antibodies were seen in all patients. Danaparoid sodium applied at a dosage of between 1.2 and 7.1 U/kg/h stopped the disease progression in each patient. Three children had a clinical recovery with partial recanalization, but for the child with peripheral arterial occlusion disease, amputation of some of the toes became necessary.
Conclusion:
Our data indicate that heparin-induced thrombocytopenia type II is a potential life-threatening disease in children and danaparoid sodium is beneficial in this age group.