Osteoporosis heparin-induced

Toxicity Bleeding, osteoporosis, heparin-induced thrombocytopenia (HIT), hypersensitivity Bleeding, skin necrosis (if low protein C), drug interactions, teratogenic (bone dysmorphogenesis)... 

Hemorrhage is the main complication that can arise from heparin therapy. Other side effects include Heparin-Induced Thrombocytopenia Syndrome (HITS), local irritation, hypersensitivity reactions and with long-term use, alopecia, hypoaldoster-onism, and osteoporosis. 

Heparins can be used during pregnancy for the management of thromboembolic disease because they do not cross the placenta. Administration of heparins should be stopped at onset of labour. Low molecular weight heparins are preferred during pregnancy since they pose lower risks of osteoporosis and of heparin-induced thrombocytopenia. 

For the past few decades, heparin has been widely used for the prevention of postoperative thiomboemboUsm (6,7). However, there are several adverse side-effects associated with the use of heparin such as bleeding, heparin induced thrombocytopenia, heparin induced thrombosis (8,9) and osteoporosis (10). In addition, the regimen of pioph actic heparin used in the prevention of deep venous thrombosis (DVT) is tedious, requiring 2 to 3 daily injections because of the limited bioavailability and short half-life of heparin when administered subcutaneously. 

The risk of osteoporosis appears to be substantially lower with the LMWHs compared with UFH. The LMWHs have not caused appreciable changes in bone mineral density after several months of use. They have been used in a limited number of patients with established heparin-induced osteoporosis. Although these reports are promising, it cannot be concluded that the LMWHs have no effect on bone formation until well-designed clinical trials are available. 

Le Templier G, Rodger MA. Heparin-induced osteoporosis and pregnancy. Curr Opin Pulm Med 2008 14(5) 403-7. 

Qassification Idiopathic osteoporosis type 1, occurring in postmenopausal females type 11, occurring in senescent males and females (>70 y). Secondary osteoporosis associated with primary disorders such as Cushing s disease, or induced by drugs, e.g chronic therapy with glucocorticoids or heparin. In these forms, the cause can be eliminated. 

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