Rinsho byori. The Japanese journal of clinical pathology
-
EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is a phenomenon caused by EDTA-dependent anti-platelet antibody. This antibody induces platelet agglutination in vitro, resulting in a decrease in platelet counts. It is necessary for clinicians to consider the possible presence of PTCP in cases of patients having low platelet counts without any hemorrhagic tendency. In this article, we describe some aspects of EDTA-PTCP including, (1) characteristics of platelet agglutination, (2)possible mechanisms for antibody production, (3) several methods to determine the true platelet number, and also (4) a few similar phenomena induced by antibodies independent of EDTA.
-
Heparin-induced thrombocytopenia(HIT) due to immunological mechanisms is known as an important adverse reaction to heparin treatment, and heparin treatment should be applied while keeping in mind the risk of onset of HIT 5-14 days after the initiation of heparin. The presence of HIT had not been fully recognized in clinical practice in Japan despite the management of HIT being well confirmed in Western countries. Recognition of HIT has increased since argatroban, a direct thrombin inhibitor, obtained the approval of the FDA for prevention and treatment of HIT. ⋯ Treatment of HIT should be started at the time of recognition of thrombocytopenia while antibody testing for HIT is performed. As an alternative anticoagulant to heparin, argatroban should immediately be applied to avoid complication of thrombosis. Thrombocytopenia and hypercoagulability quickly recover to the preheparin level by the appropriate use of argatroban.