血液透析患者におけるヘパリン起因性血小板減少症(HIT)(<特集>血小板減少症とアフェレシス)

概要

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Heparin is frequently used during hemodialysis as the anticoagulant. Bleeding is well known as the serious side effect of heparin. Recently, heparin induced thrombocytopenia (HIT), which is a thrombotic side effect of heparin, attracted much attention. We found more patients with HIT during the introduction of hemodialysis than those during the chronic phase of hemodialysis. In Nara Medical University Hospital, 89% of patients with HIT were found during the introduction of hemodialysis. If we found thrombocytopenia and clot formation in dialyzers and extracorporeal circuits in hemodialysis patient, we should diagnose HIT based on a clinical finding such as the HIT scoring system "4Ts". For suspected patients with HIT, we should stop the usage of heparin promptly and change the anticoagulant to argatroban, a direct thrombin inhibitor, before the result of HIT antibody becomes clear.
2012-02-29