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[Efficacy of azidothymidine in thrombopenia associated with HIV infection].

We report an observation where a patient suffering HIV related thrombocytopenia was followed up for 23 months. Introduction or reintroduction of azidothymidine obtained a raise of platelet rate. When azidothymidine was stopped, platelet rate climbed down. This observation is in agreement with recent data suggesting efficiency of azidothymidine on HIV related thrombocytopenia.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Ischemic vascular complications following thrombopenia induced by heparin. Diagnostic and therapeutic problems].

The authors report 21 cases of heparin-induced thrombocytopenia with ischemic vascular complications. The clinical presentations were peripheral arterial ischemia (16 cases), hemiplegia (1 case) and deep vein thrombosis (4 cases). The vascular surgeon confronted by these complications in an emergency situation should recognise the difficulties of clinical diagnosis (atypical forms) and biological investigations (problems of tests of platelet aggregation). Arterial occlusions are usually accessible to disobliteration with a Fogarty catheter without peroperative heparinisation. Delayed diagnosis explains the seriousness of these complications; in our series of 21 patients, there were 2 deaths, 1 paraplegia, 4 amputations due to arterial problems, 4 severe post-deep vein thrombosis conditions, two of which followed trans-metatarsal amputation. The diagnosis of heparin-induced thrombocytopenia implies immediate withdrawal of heparin therapy. A relay with a low molecular weight heparin is not without risk and should only be undertaken after a negative platelet aggregation test (with the low molecular weight heparin). These tests are rarely practicable in emergency situations and a relay using oral anti-vitamin K antagonists with a rapid onset of action is probably the safest option.

Adult↗
PubMed1988

[Disseminated coronary thrombosis and thrombopenia induced by pentosan polysulfate].

Pentosan polysulfate may induce severe thrombocytopenia by an immunoallergic mechanism similar to that observed with heparin. We report five cases of serious arterial and venous thrombosis associated with pentosan polysulfate-induced thrombocytopenia: --two cases of fatal circumferential myocardial infarction due to disseminated thrombosis in patients whose coronary vessels were free from atheroma at angiography. Such cases have not previously been published. They seem to represent an unusual and dangerous manifestation of immunoallergic thrombocytopenia complicated by diffuse intravascular coagulation and induced by pentosan polysulfate; --two cases of myocardial infarction with favourable outcome; one of them was associated with hemiplegia with aphasia; --one case of extensive phlebitis of the inferior vena cava. The diagnosis was suspected on the ground that the patients had previously been treated with intramuscular pentosan polysulfate for 8 to 10 days and had less than 100,000 platelets per mm3; it was confirmed by in vitro platelet aggregation tests. Cross-allergy with heparin was present in all cases. Out of 18 published cases of pentosan polysulfate-induced thrombocytopenia, 15 were revealed by thrombosis of a coronary, cerebral or peripheral artery (80 p. 100) or of a vein (20 p. 100). Arterial thrombosis carries a 50 p. 100 risk of death, and for this reason pentosan polysulfate should be subjected to the same rules of prescription and monitoring as heparin.

Aged↗
PubMed1988

[Venous thrombosis in the brain and upper limbs associated with thrombopenia induced by pentosan polysulfate].

The authors report a new observation of thrombocytopenia thrombosis syndrome induced by a synthetic heparinoid: pentosan polysulfate and presenting with dural sinus thrombosis. This syndrome was aggravated by standard heparin therapy. Thrombocytopenia was due to an immunological mechanism and preceded thrombotic phenomena, so emphasizing the need for platelet counts in all patients considered for heparin or synthetic heparinoid therapy.

Adult↗