Pediatric Heparin-Thrombocytopenia-Thrombosis Syndrome

Pediatric heparin-thrombocytopenia-thrombotic syndrome Heparin-thrombocytopenia-thrombo-genesissyndrome, heparin has been widely used in clinical applications in recent years, and its indications are also increasing, but about 2% to 30% after heparin is applied. A group of syndromes such as thrombocytopenia or thrombocytopenia with thrombosis, clinical bleeding and thromboembolism, known as heparin-thrombocytopenia-thrombosis syndrome. basic knowledge The proportion of illness: 0.001% Susceptible people: young children Mode of infection: non-infectious Complications: pulmonary hypertension myocardial infarction

Pediatric heparin-thrombocytopenia-cause syndrome

( 1) Causes of the disease

The cause of this disease is related to the use of heparin.

(two) pathogenesis

This disease occurs after the use of heparin, its mechanism has not been elucidated, most scholars believe that the immune mechanism is caused, because heparin-dependent platelet antibodies can bind to heparin and platelets, activate complement, make platelet synthesis thromboxane A2 and release ADP, etc. Platelet aggregation, and also release platelet III, factor IV, participate in endogenous system coagulation and anti-heparin effect, heparin also has anti-vascular endothelial prostacyclin (PGI2) effect, low-dose heparin can block protein C Activation is beneficial for platelet aggregation and thrombosis. In addition, heparin impure is also a possible factor. The current observation results show that the probability of thrombocytopenia after heparin preparation from pigs is 0% to 8.2%, while bovine lung The prepared heparin can be as high as 7.5% to 26%, which is the purity of the preparation or other reasons are still under investigation.

Pediatric heparin-thrombocytopenia-thrombosis syndrome prevention

Improve the understanding of this disease, the use of heparin should pay attention to identification.

Pediatric heparin-thrombocytopenia-thrombosis syndrome complications Complications pulmonary hypertension myocardial infarction

Can cause dyspnea, pulmonary hypertension, myocardial infarction or DIC.

Pediatric heparin-thrombocytopenia-thrombotic syndrome symptoms common symptoms bleeding tendency venous thrombosis microthrombus thrombocytopenia intravascular coagulation pulmonary embolism coronary embolism

Have a history of application of heparin, 2 to 14 days after the application of heparin, more than 5 days after thrombocytopenia, hemorrhage and vein, arterial thrombosis, can show pulmonary embolism or involving coronary vessels, brain and gastrointestinal artery corresponding symptoms, and even Diffuse intravascular coagulation (DIC).

Pediatric heparin-thrombocytopenia-thrombosis syndrome examination

1. Thrombocytopenia Blood tests significantly reduce peripheral blood platelets, and after heparin is used, platelets are reduced again.

2. Platelet aggregation factor Heparin-dependent platelet aggregation factor, which can occur at the same time as thrombocytopenia and lasts for several months, is a more specific laboratory diagnostic indicator with a positive rate of about 70%.

3. Serotonin release test Although the serotonin release test is sensitive and specific, it is more complicated, requires a lot, and is difficult to promote.

According to the clinical selection of chest X-ray, ECG, CT, angiography and other examinations.

Diagnostic identification of heparin-thrombocytopenia-thrombosis syndrome in children

After heparin thrombocytopenia and other causes of thrombocytopenia, if thrombocytopenia is accompanied by acute arterial thrombosis that can be explained by other reasons, combined with laboratory results, the disease can be affirmative diagnosis, if The diagnosis is more reliable by measuring the heparin-dependent platelet aggregation factor or serotonin release test in the patient's serum.

Differentiated from DTC.

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