HEPARIN-ASSOCIATED THROMBOCYTOPENIA - LOW-FREQUENCY IN 104 PATIENTS TREATED WITH HEPARIN OF INTESTINAL MUCOSAL ORIGIN

Abstract

Patients (104) receiving heparin obtained from porcine intestinal mucosa for 4 or more days were studied to determine the frequency of associated significant thrombocytopenia (platelet count less than 100 .times. 109/l on 2 consecutive days). No episodes of significant thrombocytopenia were identified in the 13 patients receiving heparin by continuous i.v. infusion for a mean of 8.0 days or in the 38 patients receiving heparin s.c. for a mean of 9.9 days. In 1 of 26 patients receiving heparin as intermittent i.v. boluses for a mean of 8.2 days significant thrombocytopenia developed; this patient had laboratory evidence of disseminated intravascular coagulation. In none of the 17 patients receiving uninterrupted heparin therapy for 4 or more days by more than 1 route of administration but for less than 4 days by any single route did significant heparin-associated thrombocytopenia develop. Of the 104 patients 13 had 1 or more platelet counts of less than 150 .times. 109/l; in most it was not possible to definitely relate the thrombocytopenia to the heparin therapy. Platelets in normal platelet-rich plasma did not aggregate when heparin and serum from patients with thrombocytopenia were added. The frequency of heparin-associated thrombocytopenia was considerably lower than that reported previously.