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. 2021 May 7;2(3):466-470.
doi: 10.1002/jha2.211. eCollection 2021 Aug.

Bleeding is associated with intravenous immunoglobulin and therapeutic plasma exchange use in heparin-induced thrombocytopenia: A propensity matched analysis

Alexandre Soares Ferreira Júnior  1   2 , Stephen H Boyle  3 , Maragatha Kuchibhatla  4 , Oluwatoyosi A Onwuemene  5
Affiliations

Bleeding is associated with intravenous immunoglobulin and therapeutic plasma exchange use in heparin-induced thrombocytopenia: A propensity matched analysis

Alexandre Soares Ferreira Júnior et al. EJHaem. .

Abstract

Intravenous immunoglobulin (IVIG) and therapeutic plasma exchange (TPE) are used in select cases with heparin-induced thrombocytopenia (HIT). In a cross-sectional analysis, a propensity matched sample was generated by IVIG or TPE treatment status to assess the primary outcome of mortality. In 500 HIT cases, IVIG or TPE was not associated with increased mortality (OR = 1.46; 95% CI: 0.81-2.63, p = 0.2052) but was associated with a higher likelihood of major bleeding (OR = 1.75; 95% CI: 1.03-2.96, p = 0.0376). The use of IVIG or TPE in HIT cases with bleeding contraindications to standard therapies should be further investigated.

Keywords: National Inpatient Sample; heparin‐induced thrombocytopenia; intravenous immune globulin; therapeutic plasma exchange.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

    1. Cuker A, Arepally GM, Chong BH, Cines DB, Greinacher A, Gruel Y, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin‐induced thrombocytopenia. Blood Adv. 2018;2(22):3360–92. - PMC - PubMed
    1. Padmanabhan A, Connelly‐Smith L, Aqui N, Balogun RA, Klingel R, Meye E, et al. Guidelines on the use of therapeutic apheresis in clinical practice—evidence‐based approach from the Writing Committee of the American Society for Apheresis: the eighth special issue. J Clin Apher. 2019;34(3):171–354. - PubMed
    1. Onuoha C, Barton KD, Wong ECC, Raval JS, Rollins‐Raval MA, Ipe TS, et al. Therapeutic plasma exchange and intravenous immune globulin in the treatment of heparin‐induced thrombocytopenia: a systematic review. Transfusion 2020;60(11):2714–36. - PubMed
    1. Warkentin TE, Sheppard J‐AI, Chu FV, Kapoor A, Crowther MA, Gangji A. Plasma exchange to remove HIT antibodies: dissociation between enzyme‐immunoassay and platelet activation test reactivities. Blood 2015;125(1):195–8. - PubMed
    1. Padmanabhan A, Jones CG, Pechauer SM, Curtis BR, Bougie DW, Irani MS, et al. IVIg for treatment of severe refractory heparin‐induced thrombocytopenia. Chest 2017;152(3):478–85. - PMC - PubMed