The pathogenesis of venous limb gangrene associated with heparin-induced thrombocytopenia

Article Abstract:

Venous limb gangrene may sometimes be precipitated by treatment with the anticoagulant warfarin in patients with heparin-induced thrombocytopenia. The records of 158 patients who had severely reduced platelet counts after heparin therapy were examined. Eight patients developed acute symptomatic blood clots in the deep veins and gangrene of a limb after heparin was discontinued and warfarin therapy was begun or continued. Abnormalities in the clotting studies of these patients suggest that warfarin may contribute to an imbalance of the natural coagulation pathways. Incipient gangrene was resolved in one patient after discontinuing treatment with warfarin.

Causes of, Complications and side effects, Thrombocytopenia, Warfarin, Gangrene

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Splenectomy done during hematologic remission to prevent relapse in patients with thrombotic thrombocytopenic purpura

Article Abstract:

Patients with thrombotic thrombocytopenic purpura who have their spleen removed may experience fewer relapses. Thrombotic thrombocytopenic purpura is a rare bleeding disorder which causes hemorrhage into the tissues. Six patients with the bleeding disorder who were in remission had their spleen removed. During the next 10 years, there were only 3 relapses in the group, compared to 26 in the 10-year period before surgery. The operation also reduced the number of plasma exchange procedures used to control the disease.

Surgery

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High-dose intravenous immune globulin and the response to splenectomy in patients with idiopathic thrombocytopenic purpura

Article Abstract:

The response of patients with idiopathic thrombocytopenic purpura to immune globulin may predict their response to spleen removal. Idiopathic thrombocytopenic purpura occurs when autoantibodies destroy platelets. It can be treated by removing the spleen, but many patients do not benefit. A study of 30 patients who received immune globulin before spleen removal found that those who responded to immune globulin also benefitted from spleen removal. Those who responded poorly did not benefit from spleen removal.

Care and treatment, Immunoglobulins

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