Heparins systemic lupus

Suzuki S, Sakamoto S, Okada T et al. Acute myocardial infarction caused by delayed heparin-induced thrombocytopenia and acute immunoreaction due to re-exposure to heparin in a systemic lupus erythematosus patient with HIT antibodies, Clin Appl Thromb Hemost 2003 9 341-346,... 

Thrombotic thrombocytopenic purpura is a rare acute or subacute disease in adults, rather similar to the hemolytic uremic syndrome in children, in which there is systemic malaise, fever, skin purpura, renal failure, hematuria and proteinuria. Hemorrhagic infarcts caused by platelet microthrombi occur in many organs in the brain they may cause stroke-like episodes (Matijevic and Wu 2006) although more commonly there is global encephalopathy. The blood film shows thrombocytopenia, hemolytic anemia and fragmented red cells. The differential diagnosis includes infective endocarditis, idiopathic thrombocytopenia, heparin-induced thrombocytopenia with thrombosis, systemic lupus erythematosus, non-bacterial thrombotic endocarditis and disseminated intravascular coagulation. 

Thrombocytopenia. Abnormal decrease in the number of thrombocytes below normal values. Frequently detected in patients with autoimmune diseases (e.g. systemic lupus erythematosus, -Sjogren syndrome, mixed connective tissue disease, antiphospholipid syndrome). Primary forms may be drug induced ( - heparin-induced thrombocytopenia) or mediated by antiplatelet antibodies ( - idiopathic thrombocytopenic purpura). 

However, false positive tests for platelet factor 4/heparin antibodies can occur in patients with the phospholipid antibody sjmdrome or systemic lupus er)4 hematosus, as illustrated by the results of a study in 42 such patients, of whom 32 were positive for platelet factor 4/heparin IgG antibodies and 24 were positive for platelet factor 4 antibodies [75. However, there were no abnormalities in heparin-induced platelet activation or aggregation. 

Pauzner R, Greinacher A, Selleng K, Althaus K, Shenkman B, Seligsohn U. False-positive tests for heparin-induced thrombocytopenia in patients with antiphospholipid syndrome and systemic lupus erythematosus. J Thromb Haemost 2009 7(7) 1070-4. 

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