Heparin-associated thrombocytopenia: an update.


:The use of heparin may be complicated by two types of thrombocytopenia (HAT): type I occurs early, is transient, and has no clinical relevance, while type II may lead to very severe manifestations (arterial or venous thromboses and more rarely bleedings), that are still underestimated by some clinicians. HAT-type II most frequently develops after use of therapeutic doses of unfractionated heparin (UH) but has also been described less frequently after use of very low doses of UH, of low molecular weight heparins (LMWH), and even of polysulfated glycosaminoglycosans devoid of anticoagulant action. The estimation of the incidence of HAT-type II and of related thromboses is a very difficult matter. Recent observations suggest that thromboses (notably venous) may be more frequent than previously estimated. HAT-type II pathophysiology includes the formation of immune complexes at the surface of platelets; the antigen has been shown to be most often platelet factor 4 bound to heparin while the antibody is recognized by platelet Fc gamma RII receptors. Thromboses result most probably from activation of both platelets (leading to the formation of microparticles) and endothelial cells. Several biological tests are presently available for diagnosing HAT-type II but none of them has been shown to be ideal. The prevention of HAT-type II requires history taking preference of LMWH to UH, early start of oral anticoagulation, and platelet monitoring from the fifth day of heparin therapy. The therapy of HAT-type II implies immediate discontinuation of heparin and avoidance of platelet transfusions, unless severe bleeding occurs. If further antithrombotic treatment is deemed necessary (probably in all cases), several options are possible but presently, the most recommended ones are Org 10172 or Ancrod; embolectomy or thrombolysis may also be required if a new thrombotic event has developed. A very difficult dilemma concerns patients previously sensitized to heparin and who present a clinical situation that theoretically mandates re-exposure to UH, such as by-pass surgery; prostacyclin analogues may be successfully used in such cases. Recent developments in the therapy of HAT-type II include recombinant hirudin or synthetic analogs, or use of some intravenous immunoglobulin preparations. Possible candidates are the heparin synthetic pentasaccharide and recombinant tissue factor pathway inhibitor.


Acta Clin Belg


Acta clinica Belgica


Fondu P




Has Abstract


1995-01-01 00:00:00












  • Application of the GheOP3S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations.

    abstract::Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Foubert K,Muylaert P,Mehuys E,Somers A,Petrovic M,Boussery K

    更新日期:2020-12-01 00:00:00

  • Recurrent pleuro-pericarditis due to gastrodiaphragmatic fistula.

    abstract::A 61-year-old woman presented with recurrent pleuro-pericarditis following Nissen fundoplication. A diagnosis of anterior gastrodiaphragmatic fistula was made. The suspected etiology of the fistula was local ischemia. This kind of fistula, although exceptional, should always be considered in the presence of unexplaine...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Descamps OS,Donckier JE,Collard JM,Michel L,Trigaux JP,Melange M,Buysschaert M

    更新日期:1990-01-01 00:00:00

  • Usage criminel de substances psycho-actives : le problème de la durée de détection.

    abstract::On a regular basis, the media presents the potential risks of the use of psycho-active compounds, including misused pharmaceuticals (flunitrazepam, GHB) or drugs of abuse (cannabis, LSD, ecstasy). Ethanol is also frequently encountered. These drugs can be used for recreational purposes by addicts or can be observed af...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Kintz P,Villain M,Cirimele V,Goullé J,Ludes B

    更新日期:2002-01-01 00:00:00

  • Flow-assisted basophil activation tests in immediate drug hypersensitivity: two decades of Antwerp experience.

    abstract::The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Mangodt EA,Van Gasse AL,Bastiaensen A,Decuyper II,Uyttebroek A,Faber M,Sabato V,Bridts CH,Hagendorens MM,De Clerck LS,Ebo DG

    更新日期:2016-02-01 00:00:00

  • Pulmonary rehabilitation and non-invasive ventilation in COPD.

    abstract::A multidisciplinary pulmonary rehabilitation program has become an important part of the treatment of chronic obstructive pulmonary disease. It can improve both exercise tolerance and health related quality of life in these patients. Exercise training has to be included for the program to be successful. The intensity ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: De Backer LA,Ides K,Daems D,Dieriks B,De Backer WA,Germonpre P

    更新日期:2010-09-01 00:00:00

  • Does serum 25 hydroxy vitamin D level predict disease activity in ulcerative colitis patients?

    abstract:BACKGROUND/AIM:There are controversial results regarding the relationship of serum 25 hydroxy vitamin D [25(OH)D] and ulcerative colitis (UC) activity. To address this issue, the current study was designed to evaluate the correlation of serum 25(OH)D level and disease activity in patients with UC. METHOD:All consecuti...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Dolatshahi S,Pishgar E,Jamali R

    更新日期:2016-02-01 00:00:00

  • Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

    abstract::Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-spe...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Olesen TK,Denys MA,Vande Walle J,Everaert K

    更新日期:2018-08-01 00:00:00

  • The use of acetyl cholinesterase inhibitors and memantine in nursing home residents.

    abstract:AIM:Although a high proportion of elderly nursing home residents suffer from Alzheimer's disease (AD), data from the literature indicate that they are only rarely treated with Acetyl Cholinesterase Inhibitors (ChEls) or memantine. The aim of this study was to describe the use of ChEls or memantine by elderly residents ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,多中心研究


    authors: Gorus E,Van Puyvelde K,Corremans V,Mets T

    更新日期:2011-09-01 00:00:00

  • Q fever: a contemporary case series from a Belgian hospital.

    abstract:OBJECTIVES:Q fever is a global zoonosis that can cause both acute and chronic infections in humans through aerogenic transmission. Although Q fever was discovered already 80 years ago, this infectious disease remains largely unknown. We studied a case series in a Belgian tertiary care hospital. METHODS:A laboratory an...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Vanderbeke L,Peetermans WE,Saegeman V,De Munter P

    更新日期:2016-10-01 00:00:00

  • Short-term return visits of 'general internal medicine' patients to the emergency department: extent and risk factors.

    abstract:OBJECTIVES:Although emergency department (ED) return visits are a significant problem universally, it has not been previously studied in our ED. The aim of this study was to determine the extent of the problem in our ED, to identify the relevant clinical predictor variables and to detect diagnostic errors. METHODS:A r...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Vanbrabant P,Knockaert D

    更新日期:2009-09-01 00:00:00

  • [Malignant mitral valve prolapse: apropos of a case].

    abstract::The authors report the case of a 67-year-old woman, with mitral valve prolapse, for more than 20 years. She recently complained of attacks of syncope and clinical ventricular tachycardia; ventricular fibrillation was induced during programmed stimulation. The patient seemed to be at high risk for sudden cardiac death,...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Van Caenegem O,Chaudron JM,Scavée C,de Meester A

    更新日期:1996-01-01 00:00:00

  • Successful fibrinolytic treatment of prosthetic heart valve thrombosis using streptokinase.

    abstract:OBJECTIVES:This study aims to evaluate the clinical outcome of fibrinolytic treatment of prosthetic valve thrombosis (PVT) with 'streptokinase' as a first line treatment for these cases. METHODS:The study group was 20 consecutive patients (10 females) diagnosed with PVT. The protocol for streptokinase administration w...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Sakr SA,Abdel-Shakour H,Ramadan MM

    更新日期:2015-06-01 00:00:00

  • Comparisons between psychotropic drugs: must the risk of side effects dictate our practices?

    abstract:OBJECTIVES:Recently, SOHO and CATIE's studies in the field of schizophrenic disorders asserted that molecules apparently showing the most side-effects are not only the most effective but also lead to the least changes in treatments. Can we generalise this assertion to other domains of pharmacological treatments, such a...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Zdanowicz N,Jacques D,Reynaert C

    更新日期:2008-07-01 00:00:00

  • Cause D'Erreur Dans La Lecture Des Antibiogrammes : Présence, Non Déclarée, D'Un Antiseptique Sur Les Disques.

    abstract::There is a need for legal control of sensitivity discs. False results are obtained by the use of discs containing an antibiotic and an unlabelled antimicrobial drug. Results of sensitivity tests (performed by the disc agar diffusion method) using Levocyclin8 discs furnished by the manufacturers were highly improbable....

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Yourassowsky E,Dony J,De Roeck A,De Keere V,Schoutens E,Vanderlinden MP,Palsterman V

    更新日期:1976-01-01 00:00:00

  • [Evaluation of six rapid tests for screening of cannabis in sweat, saliva and tears].

    abstract::In order to demonstrate an intake of cannabis, there are a number of rapid tests, all of them being focused on urine. In this study, we evaluated the results of six tests when applied to sweat (DrugWipe), saliva and urine (Syva Rapidtest, Biomedix, Frontline, DrugWipe, Cortez Dako). Fifty regular users of cannabis and...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Mura P,Kintz P,Papet Y,Ruesch G,Piriou A

    更新日期:1999-01-01 00:00:00

  • Time course of iron metabolism in critically ill patients.

    abstract:BACKGROUND:Altered iron metabolism plays a central role in the development of anaemia in critically ill patients but the time course of iron status in septic and non-septic critically ill patients has not been well defined. METHODS:Prospective study in a 34-bed medico-surgical ICU. The complete blood count, iron, ferr...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Piagnerelli M,Cotton F,Herpain A,Rapotec A,Chatti R,Gulbis B,Vincent JL

    更新日期:2013-01-01 00:00:00

  • Microvesicular steatosis of the liver.

    abstract::The term "microvesicular steatosis of the liver" refers to a variant form of hepatic fat accumulation whose histologic features contrast with the much more common macrovesicular steatosis. Microvesicular steatosis of the liver was originally described in association with conditions who share a number of biochemical an...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Hautekeete ML,Degott C,Benhamou JP

    更新日期:1990-01-01 00:00:00

  • Type 1 (insulin-dependent) diabetes mellitus: an autoimmune, predictable and preventable disease? Lessons from national registries and new challenges to clinical biology.

    abstract::Type 1 (insulin-dependent) diabetes mellitus is a frequent chronic disease that affects children as well as adults. The disease keeps a life-long burden on patients, their environment and society. Although still incompletely understood, its pathogenesis becomes progressively unravelled. Autoimmune phenomena play an im...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Gorus FK,Anselmo J,Keymeulen B

    更新日期:1993-01-01 00:00:00

  • A randomized placebo controlled trial on the effects of simvastatin, a HMG-CoA reductase inhibitor, on blood lipids and fibrinolytic parameters.

    abstract::Coronary artery disease is frequently associated with disturbed blood lipids and with a deficient blood fibrinolytic capacity. In order to investigate a possible link between hypercholesterolemia and hypofibrinolysis, we have investigated the effect of simvastatin, a HMG-CoA reductase inhibitor, on blood lipids and fi...

    journal_title:Acta clinica Belgica

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Jacobs H,Van de Werf F,Lesaffre E,De Geest H,Collen D

    更新日期:1992-01-01 00:00:00

  • Bone metastases and age are associated with earlier dose reductions in metastatic clear-cell renal cell carcinoma patients treated with angiogenesis inhibitors.

    abstract::Background: Metastatic clear-cell renal cell carcinoma (m-ccRCC) patients with bone metastases (BM) treated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI) have a poorer outcome compared to patients without BM. We aimed to investigate whether an increased incidence of VEGFR-TK...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Haaker L,De Meue E,Wildiers H,Verbiest A,Dumez H,Lerut E,Pans S,Albersen M,Beuselinck B

    更新日期:2019-12-01 00:00:00

  • Successful infliximab therapy in a patient with comorbid spondyloarthritis, primary biliary cirrhosis and generalized morphea.

    abstract::The patient in this report was diagnosed simultaneously with primary biliary cirrhosis (PBC), spondyloarthritis, and generalized morphea and was started on infliximab therapy. In addition to an improvement in clinical symptoms with this therapy, an improvement was also observed in laboratory parameters such as cholest...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Resorlu H,Kılıc S,Isık S,Gokmen F

    更新日期:2017-10-01 00:00:00

  • Macroprolactinemia: clinical significance and characterization of the condition.

    abstract::The purpose of this study was to characterize the clinical picture of macroprolactinemic patients and to further assess whether macroprolactinemia was part of an auto-immune syndrome. Eighty-two hyperprolactinemic (serum PRL > 1000 mU/l) patients were investigated and the PEG precipitation test identified 14 patients ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Theunissen C,De Schepper J,Schiettecatte J,Verdood P,Hooghe-Peeters EL,Velkeniers B

    更新日期:2005-09-01 00:00:00

  • Hypothermia and Hodgkin's disease: case report and review of the literature.

    abstract::We reported the case of a patient with stage IV Hodgkin's disease (involving the nodes and Liver) presenting with paraneoplastic fever and who subsequently developed hypothermia during chemotherapy administration. We also reviewed the 12 other cases of hypothermia in Hodgkin's disease reported in the literature and di...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Meert AP,Berghmans T,Sculier JP

    更新日期:2006-09-01 00:00:00

  • Primary sclerosing cholangitis and idiopathic pulmonary fibrosis: a case report.

    abstract::Primary sclerosing cholangitis (PSC) and idiopathic pulmonary fibrosis (IPF) were each separately described in association with a variety of chronic idiopathic inflammatory diseases such as retroperitoneal fibrosis, Sicca complex or Riedel's thyroiditis. We report a case which may be the first description of the assoc...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Jonard P,Geubel A,Wallon J,Rahier J,Dive C,Meunier H

    更新日期:1989-01-01 00:00:00

  • Repetitive analyses of P-glycoprotein in chronic myeloid leukaemia.

    abstract::P-glycoprotein, a pump located in the plasma cell membrane, extrudes several clinically important drugs from the cell, and hence causes multidrug resistance. Reversing clinical drug resistance is possible by using agents that inhibit the activity of P-glycoprotein. We describe the results of sequential flow cytometric...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: De Moerloose B,Muylaert A,Gemmel F,Janssens A,Poppe B,Dhooge C,Benoit Y,Van Hove W,Philippé J

    更新日期:2000-07-01 00:00:00

  • Atypical presentation of acute coronary syndrome (ACS): a case report.

    abstract:CASE:A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and isch...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Van Damme A,Vanderheeren P,De Backer T,Desimpel F

    更新日期:2018-12-01 00:00:00

  • Prevalence of Bordetella holmesii and Bordetella bronchiseptica in respiratory tract samples from Belgian patients with pertussis-like symptoms by sensitive culture method and mass spectrometry.

    abstract::Insertion sequences IS481 and IS1001 are targets for molecular detection of respectively Bordetella pertussis and Bordetella parapertussis. There is a raising concern about specificity of these targets due to sequence similarity with Bordetella holmesii and Bordetella bronchiseptica. The likelihood of false (para)pert...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Van den Bossche D,De Bel A,De Smet D,Heylen O,Vekens E,Vandoorslaer K,Soetens O,Piérard D

    更新日期:2013-09-01 00:00:00

  • [Hypothalamic hypopituitarism with hyperphagia and subacute dementia due to neurosarcoidosis: case report and literature review].

    abstract::The frequency of neurologic involvement in sarcoidosis is about 5%. When the clinical picture presents with only neurological manifestations, as it did in our patient, the diagnosis at presentation is often difficult. Involvement of other tissues must therefore be actively searched. We describe a case of neurosarcoido...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Vanhoof J,Wilms G,Bouillon R

    更新日期:1992-01-01 00:00:00

  • 18-fluoro-deoxyglucose positron emission tomography may contribute to the diagnosis and follow-up of malakoplakia.

    abstract::Malakoplakia is a rare inflammatory disease involving most frequently the urinary tract. We present a case of bilateral renal malakoplakia, in which FDG-PET contributed to diagnosis. We made this diagnosis on the basis of clinical presentation, renal biopsy showing a mixed cellular infiltrate with granuloma formation ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Vanbrabant P,Drieskens O,Blockmans D

    更新日期:2004-05-01 00:00:00

  • Epidemiology of AKI in the ICU.

    abstract::Up to a little while ago there was no uniform definition for acute kidney injury (AKI). Recently, the Acute Dialysis Quality Initiative proposed the RIFLE consensus classification for AKI. This classification was adapted and modified by the Acute Kidney Injury Network into the AKI staging system. This classification d...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Hoste EA,De Corte W

    更新日期:2007-01-01 00:00:00