Lethal heparin-associated XXXX --case reports.

@entity1 @entity1605 @entity882 @entity64335 @entity1151 @entity1031
@entity882 is a known adverse reaction occurring in some @entity1 receiving heparin. Two different types of heparin-induced @entity882 have been described. Heparin-induced @entity64335 is a mild @entity882 after 1 to 4 days of heparin therapy, attributed to a direct interaction between heparin and circulating platelets. No specific treatment is necessary. Heparin-induced @entity882 is a severe @entity882 mediated by an immunologic mechanism. @entity1605 generally develops after 5 to 10 days of heparin therapy and can be associated with potentially devastating @entity1031 . The incidence of heparin-induced @entity882 is below 3%. @entity1031 events are always accompanied by a decrease in the platelet count, however, complications in the absence of absolute @entity882 have been reported. Diagnosis of HIT type II is based on clinical features and laboratory studies for the heparin-dependent platelet antibody. Immediate cessation of heparin administration is essential. Several alternative anticoagulant therapies have been studied and have shown promising results when used for this purpose. Two @entity1 undergoing coronary artery bypass surgery are presented in whom @entity1151 developed due to heparin-induced @entity882 . In both cases, platelet counts were within the subnormal range at the time of the first @entity1031 . The clinical, therapeutic, and prognostic implications are discussed.
