Yves Gruel1,2, Caroline Vayne1,2, Jérôme Rollin1,2, Pierre Weber2, Dorothée Faille3, Anne Bauters4, Laurent Macchi5, Martine Alhenc-Gelas6, Aurélien Lebreton7, Emmanuel De Maistre8, Sophie Voisin9, Valérie Gouilleux-Gruart1,10, Julien Perrin11, Brigitte Tardy-Poncet12, Ismail Elalamy13, Cécile Lavenu-Bombled14, Christine Mouton15, Christine Biron16, Catherine Ternisien17, Fabienne Nedelec-Gac18, Jérôme Duchemin19, Emmanuelle De Raucourt20, Isabelle Gouin-Thibault21, Lucia Rugeri22, Bernard Tardy23, Bruno Giraudeau24, Théodora Bejan-Angoulvant1,25, Claire Pouplard1,2. 1. EA 7501, GICC, Université de Tours, Tours, France. 2. Service d'Hématologie-Hémostase, CHRU Tours, Tours, France. 3. Laboratoire d'Hématologie, Hôpital Bichat, Paris, France. 4. Département d'Hémostase et Transfusion, CHU Lille, Lille, France. 5. Laboratoire d'Hématologie, CHRU Angers, Angers, France. 6. Laboratoire d'Hématologie, HEGP Paris, Paris, France. 7. Laboratoire d'Hématologie, CHRU Clermont-Ferrand, Clermont-Ferrand, France. 8. Laboratoire d'Hématologie, CHRU Dijon, Dijon, France. 9. Laboratoire d'Hématologie, CHRU Toulouse, Toulouse, France. 10. Laboratoire d'Immunologie, CHRU Tours, Tours, France. 11. Laboratoire d'Hématologie, CHRU Nancy, Nancy, France. 12. Laboratoire d'Hématologie, CHRU Saint-Etienne, Saint-Etienne, France. 13. Laboratoire d'Hématologie, Hôpital Tenon, Paris, France. 14. Laboratoire d'Hématologie, Hôpital Henri Mondor, Créteil, France. 15. Laboratoire d'Hématologie, CHRU Bordeaux, Bordeaux, France. 16. Laboratoire d'Hématologie, CHRU Montpellier, Montpellier, France. 17. Laboratoire d'Hématologie, CHRU Nantes, Nantes, France. 18. Laboratoire d'Hématologie, CHRU Rennes, Rennes, France. 19. Laboratoire d'Hématologie, CHRU Poitiers, Poitiers, France. 20. Laboratoire d'Hématologie, Hopital Beaujon, Clichy, France. 21. Laboratoire d'Hématologie, Hopital Cochin, Paris, France. 22. Laboratoire d'Hématologie, CHRU Lyon, Lyon, France. 23. INSERM CIC 1408, Unité de soins intensifs, CHRU Saint-Etienne, Saint-Etienne, France. 24. INSERM CIC, CHRU Tours, Tours, France. 25. Département de Pharmacologie Médicale, CHRU Tours, Tours, France.
Abstract
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatments, and only a few large patient cohorts have been reported. In this study, biological and clinical data from 144 French patients with HIT were analyzed in comparison with the literature. METHODS: The diagnosis of HIT was confirmed in all patients by an immunoassay combined with serotonin release assay. In the literature, only cohorts of at least 20 HIT patients published from 1992 were selected for a comparative analysis. RESULTS: Two-thirds of patients were hospitalized in surgery and most were treated with unfractionated heparin (83.2% vs. 16.8% with low molecular weight heparin only). Thrombotic events in 54 patients (39.7%) were mainly venous (41/54). However, arterial thrombosis was more frequent after cardiac surgery (13.2% vs. 2.4% in other surgeries, p = 0.042) with a shorter recovery time (median = 3 vs. 5 days, p < 0.001). The mortality rate was lower in our series than in the 22 selected published studies (median = 6.3% vs. 15.9%). Three genetic polymorphisms were also studied and homozygous subjects FcγRIIA RR were more frequent in patients with thrombosis (37.8 vs. 18.2% in those without thrombosis, p = 0.03). CONCLUSION: This study shows that the mortality rate due to HIT has recently decreased in France, possibly due to earlier diagnosis and improved medical care. It also confirms the strong association between polymorphism FcγRIIA H131R and thrombosis in HIT. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND:Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatments, and only a few large patient cohorts have been reported. In this study, biological and clinical data from 144 French patients with HIT were analyzed in comparison with the literature. METHODS: The diagnosis of HIT was confirmed in all patients by an immunoassay combined with serotonin release assay. In the literature, only cohorts of at least 20 HITpatients published from 1992 were selected for a comparative analysis. RESULTS: Two-thirds of patients were hospitalized in surgery and most were treated with unfractionated heparin (83.2% vs. 16.8% with low molecular weight heparin only). Thrombotic events in 54 patients (39.7%) were mainly venous (41/54). However, arterial thrombosis was more frequent after cardiac surgery (13.2% vs. 2.4% in other surgeries, p = 0.042) with a shorter recovery time (median = 3 vs. 5 days, p < 0.001). The mortality rate was lower in our series than in the 22 selected published studies (median = 6.3% vs. 15.9%). Three genetic polymorphisms were also studied and homozygous subjects FcγRIIA RR were more frequent in patients with thrombosis (37.8 vs. 18.2% in those without thrombosis, p = 0.03). CONCLUSION: This study shows that the mortality rate due to HIT has recently decreased in France, possibly due to earlier diagnosis and improved medical care. It also confirms the strong association between polymorphism FcγRIIA H131R and thrombosis in HIT. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Christine S M Lee; Hai Po Helena Liang; David E Connor; Agnibesh Dey; Ibrahim Tohidi-Esfahani; Heather Campbell; Shane Whittaker; David Capraro; Emmanuel J Favaloro; Dea Donikian; Mayuko Kondo; Sarah M Hicks; Philip Y-I Choi; Elizabeth E Gardiner; Lisa Joanne Clarke; Huyen Tran; Freda H Passam; Timothy Andrew Brighton; Vivien M Chen Journal: Blood Adv Date: 2022-06-14
Authors: Jason B Giles; Heidi E Steiner; Jerome Rollin; Christian M Shaffer; Yukihide Momozawa; Taisei Mushiroda; Chihiro Inai; Kathleen Selleng; Thomas Thiele; Claire Pouplard; Nancy M Heddle; Michiaki Kubo; Elise C Miller; Kiana L Martinez; Elizabeth J Phillips; Theodore E Warkentin; Yves Gruel; Andreas Greinacher; Dan M Roden; Jason H Karnes Journal: Blood Adv Date: 2022-07-26