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












  • 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

  • Highly sensitive assays are mandatory for the differential diagnosis of patients presenting with symptoms of mast cell activation: diagnostic work-up of 38 patients.

    abstract::Mastocytosis is a heterogeneous disease caused by excessive mast cell (MC) proliferation. Diagnosis of systemic mastocytosis (SM) is based on the presence of major and minor criteria defined by the World Health Organization. Symptoms of MC activation can also occur in patients without SM or without allergic or inflamm...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Van den Poel B,Kochuyt AM,Del Biondo E,Dewaele B,Lierman E,Tousseyn T,de Hertogh G,Vandenberghe P,Boeckx N

    更新日期:2017-04-01 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

  • 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

  • Gestational diabetes: overview of the new consensus screening strategy and diagnostic criteria.

    abstract::Gestational diabetes (GDM) is a frequent medical condition during pregnancy. GDM is associated with an increased risk of complications for both the mother and the baby during pregnancy and birth. Women with GDM also have an increased risk of developing type 2 diabetes later in life. Two large randomised intervention t...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Benhalima K,Van Crombrugge P,Hanssens M,Devlieger R,Verhaeghe J,Mathieu C

    更新日期:2012-07-01 00:00:00

  • Durable response after VNCOP-B and rituximab in an elderly patient with high-grade B-cell lymphoma.

    abstract:OBJECTIVES AND METHODS: High-grade B-cell lymphoma, NOS (HGBL) have an aggressive clinical behavior and poor outcome using regimens currently employed for diffuse large B-cell lymphoma (DLBCL) such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Promising results have been reported wi...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Cencini E,Fabbri A,Schiattone L,Gentili F,Mazzei MA,Bocchia M

    更新日期:2018-12-01 00:00:00

  • Acute hemiplegia caused by a retrograde cerebral venous air embolism after central venous catheter removal: an illustrative case.

    abstract::Central venous catheters are widely used in clinical practice. Air embolism is a rare, but potentially life threatening complication of central venous catheterisation. We describe a case of collapse and transient hemiplegia after removal of central venous catheter. This was accidentally performed with the patient in u...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Van Ierssel S,Specenier P,Baar I,De Belder F,Jorens PG,Vermorken JB

    更新日期:2010-01-01 00:00:00

  • [Epidemic of hantavirus disease in Entre-Sambre-et-Meuse: year 1992-1993. Clinical and biological aspects].

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    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,多中心研究


    authors: Colson P,Damoiseaux P,Brisbois J,Duvivier E,Levecque P,Roger JM,Bouilliez DJ,McKenna P,Clement J

    更新日期:1995-01-01 00:00:00

  • Management of acute ischaemic stroke.

    abstract::Over the past few years there have been enormous changes in the management of stroke patients. General practitioners, ambulance personnel/paramedics and the general public need to be well informed that stroke is a medical emergency. Prevention of secondary brain damage by normalising vital parameters and combating fev...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: De Keyser J,Sulter G,Langedijk M,Elting JW,van der Naalt J

    更新日期:1999-10-01 00:00:00

  • HIV-associated multicentric Castleman disease: a report of 4 cases and review of the literature.

    abstract:BACKGROUND:Multicentric Castleman's disease (MCD) is a rare, non-clonal lymphoproliferative disorder characterized by constitutional symptoms, anaemia and generalised lymphadenopathy. Its incidence among the HIV-positive population seems to have increased during the past decades. AIM:The present study intends to compa...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Jonckheere S,Vandercam B,Theate I,Michaux L,Yombi JC

    更新日期:2011-01-01 00:00:00

  • QTc ınterval is prolonged in Wilson's disease with neurologic ınvolvement.

    abstract::Background Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization an...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Ozturk S,Gurbuz AS,Efe SC,Iliaz R,Banzragch M,Demir K

    更新日期:2018-10-01 00:00:00

  • Metformin and lactic acidosis in patients with type 2 diabetes--from pride and prejudice to sense and sensibility.

    abstract:AIM:To present the cases of lactic acidosis encountered in our department among metformin-treated type 2 diabetic patients and to investigate the role of contraindications to metformin use. METHODS:A survey of medical records of metformin-treated type 2 diabetic patients hospitalised for various medical conditions dur...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Papanas N,Monastiriotis C,Christakidis D,Maltezos E

    更新日期:2009-01-01 00:00:00

  • Saccharomyces cerevisiae fungemia in an elderly patient with Clostridium difficile colitis.

    abstract::Saccharomyces boulardii is widely used as a probiotic compound and is generally thought to be safe. We report one case of fungemia caused by Saccharomyces cerevisiae occurring in an elderly patient treated orally with S. boulardii in association with vancomycin for Clostridium difficile colitis. We do not recommend ad...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Cherifi S,Robberecht J,Miendje Y

    更新日期:2004-07-01 00:00:00

  • Kidney in old age.

    abstract::Epidemiological studies have shown that chronic kidney disease (CKD) is a major health problem especially in an older population. Given the growing segment of the elderly population and the important implication of renal disease on health care, this review discusses the structural and functional changes of the ageing ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Maertens S,Van Den Noortgate NJ

    更新日期:2008-01-01 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

  • 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

  • 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

  • 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

  • Long-term oxygen therapy with concentrators and liquid oxygen.

    abstract::The National Institute for Insurance of Disease and Disablement (RIZIV/INAMI) in Belgium reimburses the costs of long term oxygen therapy (LTOT) by concentrators since 1984 and by liquid oxygen since 1988 for specific categories of patients supervised by approved medical centers. Since then we prescribed these therapi...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Buyse B,Demedts M

    更新日期:1995-01-01 00:00:00

  • Disseminated Mycobacterium genavense infection in a patient with immunosuppressive therapy and lymphoproliferative malignancy.

    abstract::We present the case of a 51-year-old woman who presented a right supraclavicular mass corresponding to lymphadenitis with atypical mycobacterium (Mycobacterium genavense). Later, she developed subcutaneous purulent small nodules containing the same germ. The presence of this mycobacterium was in the context of recurre...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Numbi N,Demeure F,Van Bleyenbergh P,De Visscher N

    更新日期:2014-04-01 00:00:00

  • The one fixed point in a changing age. An analysis of half-secular trends among original papers published in The Lancet 1945-95.

    abstract::We performed a systematic survey of original papers published in The Lancet throughout the years 1945, 1946, 1970 and 1995. The Lancet was chosen due to a conservative layout through these years, and the year 1946 added to the analysis to ponder for any war-induced bias. The general layout and structure of the journal...

    journal_title:Acta clinica Belgica

    pub_type: 历史文章,杂志文章


    authors: Selvais P,Hermans M

    更新日期:2004-03-01 00:00:00

  • Fatal multiple coronary involvements in a young woman with systemic lupus erythematosus.

    abstract::We report a rare case of fulminant congestive heart failure with fatal outcome in a 21-year-old girl with systemic lupus erythematosus (SLE). A young woman was admitted in the intensive care unit for pericardial tamponade associated with disseminated coagulopathy and refractory shock secondary to multiple coronary ane...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Ha Vu N,Duttmann R,De Bels D,Devriendt J,Reper P

    更新日期:2014-12-01 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

  • Salt, the kidneys, and arterial hypertension.

    abstract::The kidneys play a major role in the regulation of the salt balance and thereby regulate blood pressure. Salt sensitivity is acquired or genetically-induced and is noted in about 50% of patients with essential hypertension. This property leads to a high cardiovascular risk. In this situation, the benefit of salt restr...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,评审


    authors: Krzesinski JM,Cohen EP

    更新日期:2007-09-01 00:00:00

  • Antineutrophil cytoplasmic antibodies (ANCA) and small vessel vasculitis.

    abstract::We report on one patient with Wegener's granulomatosis (WG) and two patients with microscopic polyangiitis (MPA). The patient with WG had signs of a respiratory infection and showed a c-ANCA pattern with proteinase 3 (PR3) specificity. The patients with MPA presented with pulmonary haemorrhage and signs of renal damag...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Mareen P,Van De Walle S,Bernaert P,Vanhouteghem H,Dierick J

    更新日期:2003-05-01 00:00:00

  • Post-transplant lymphoproliferative disorder after kidney transplantation: time to adopt monitoring of Epstein-Barr virus?

    abstract::Although post-transplant lymphoproliferative disorder is a classical complication encountered after kidney transplantation, its diagnosis can still be challenging and its outcome life-threatening. Most cases are related to Epstein-Barr virus (EBV) infection and occur mainly in the first year post-transplant, favoured ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Biller P,Michaux L,Pauw LD,Camboni A,Mourad M,Kanaan N

    更新日期:2015-06-01 00:00:00

  • In vitro and in vivo evaluation of two factor VIII concentrates virally inactivated by solvent-detergent or by pasteurization.

    abstract::The present study compares two new factor VIII preparations currently used in the treatment of haemophilia. A Factor VIII was partially purified from plasma obtained from unpaid voluntary Belgian donors in the blood transfusion centers of Lille and Amsterdam and virus-inactivated by exposure to solvent-detergent (FVII...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Peerlinck K,Arnout J,Tamise M,Vanherle A,Fondu P,Vermylen J

    更新日期:1991-01-01 00:00:00

  • Pulmonary histiocytosis X diagnosed by bone biopsy. Report of a case.

    abstract::Histiocytosis X of the lung is associated with bone lesions in 4 to 20%. We report a case in which the diagnosis was missed in spite of repeated bronchoscopies with transbronchial lavage. The diagnosis was finally established by isotope bone scan, subsequent skeletal CT-scan and bone biopsy. ...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Vandeurzen K,Delanote M,Verschakelen J,Sciot R,Decramer M

    更新日期:1994-01-01 00:00:00

  • Malignant cardiac tamponade: safety and efficacy of intrapericardial bleomycin instillation.

    abstract:BACKGROUND:Malignant cardiac tamponade is a life-threatening condition that requires prompt treatment and effective management to prevent recurrence. This paper describes safety and efficacy outcomes after intrapericardial instillation of bleomycin as well as possible predictors of survival. METHODS:We performed a 10-...

    journal_title:Acta clinica Belgica

    pub_type: 杂志文章


    authors: Defruyt L,Özpak E,Gevaert S,De Buyzere M,Vandecasteele E,De Pauw M,Tromp F

    更新日期:2020-07-05 00:00:00

  • Are ACE-inhibitors or ARB's still needed for cardiovascular prevention in high risk patients? Insights from profess and transcend.

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    journal_title:Acta clinica Belgica

    pub_type: 杂志文章,随机对照试验


    authors: Van Mieghem W,Billiouw JM,Brohet C,Dupont AG,Gazagnes MD,Heller F,Krzesinski JM,Missault L,Persu A,Piérard L,Rottiers R,Vanhooren G,Vervaet P,Herman AG

    更新日期:2010-03-01 00:00:00