[Heparin-induced thrombocytopenia with unfractionated heparin. A prospective study of inpatient treatment of internal medicine patients]. / Heparin-induzierte Thrombozytopenien unter nichtfraktioniertem Heparin. Eine prospektive Studie bei stationär behandelten internistischen Patienten.

AIM: To investigate the influence of unfractionated heparin on heparin-induced thrombocytopenia (HIT) type II. PATIENTS AND METHOD: In 162 patients with internal diseases treated therapeutically of prophylactically with unfractionated heparin (heparin sodium, heparin calcium), we carried out a prospective study to determine the incidence of HIT type I and II. 55.6% of the patients were female (n = 90) with an average age of 76.5 years (range: 25 to 96 years) and 44.4% male (n = 72) with an average age of 67.5 years (range: 17 to 93 years). A platelet count was taken regularly before the start of heparin treatment, on the first day of treatment and then every second day from day 5 to 20. Whenever HIT II was suspected, an HIPA test was performed. RESULT: Type I HIT occurred in 10%, type II in 3% of the cases. Two of the 5 patients with type II developed severe thrombotic complications. CONCLUSION: In view of the high incidence of HIT, regular platelet counts should always be carried out in patients receiving heparin treatment.

Colour coded duplex sonography in ischemic finger artery disease--a comparison with hand arteriography.

BACKGROUND: A reliable non-invasive diagnostic procedure is desirable to exclude arterial pathology in patients with pain in their fingers. PATIENTS AND METHODS: The results of colour coded duplex sonography (CCDS) in 450 finger arteries (45 hands/41 patients) were compared with findings obtained by intra-arterial digital subtraction arteriography (i.a.-DSA). The population consisted of symptomatic patients with a high risk for finger artery pathologies. RESULTS: Arteriography of the hand documented finger artery occlusion in 35.6% of these patients. CCDS is capable of detecting pathological alterations in finger arteries with high accuracy and can differentiate them from regular arteries. In patients with several diseases of the finger arteries, the ultrasound diagnosis concurred with arteriography in 93.1% of patent arteries. In patients with occluded arteries the accuracy of CCDS was 86.3%. CONCLUSION: When assessing diseases of finger arteries non-invasive CCDS should be used routinely before referring the patient to arteriography. The latter is only indicated when there is a need to image the whole arterial trunk of the upper extremity or the hand, or in case of equivocal results of CCDS.