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Heparin-induced thrombocytopenia in neurologic disease treated with unfractionated heparin

From the Institute for Experimental Haematology and Transfusion Medicine (Drs. Harbrecht and Hanfland, and B. Bastians and A. Kredteck) and Department of Neurology (Drs. Klockgether and Pohl), Rheinische Friedrich Wilhelms Universität, Bonn, Germany.

Address correspondence and reprint requests to Dr. Ursula Harbrecht, Institute for Experimental Haematology and Transfusion Medicine, Sigmund-Freud-Straße, D-53105 Bonn, Germany; e-mail: ursula.harbrecht{at}ukb.uni-bonn.de

The risk for immune-mediated heparin-induced thrombocytopenia (HIT) in neurologic patients receiving unfractionated heparin (UFH) is not known. In a prospective study of 200 patients, the authors found a 2.5% rate of HIT and a 2% rate of HIT-associated thromboses, suggesting that neurologic patients treated with UFH are at considerable risk for development of HIT and its complications. Prevalence of heparin-induced antibodies was 20.5% and was dependent on heparin dose. It was higher in cerebrovascular than in noncerebrovascular (29.4% versus 11.2%, p < 0.01) patients.

Received April 29, 2003. Accepted in final form October 17, 2003.