Generation of Anti-Hirudin Antibodies in Heparin-Induced Thrombocytopenic Patients Treated With R-Hirudin

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Generation of anti-hirudin antibodies in heparin-induced thrombocytopenic patients treated with r-hirudin.

BACKGROUND Hirudin is a small protein with strong thrombin inhibition that may be antigenic. The generation and disappearance of anti-hirudin antibodies were investigated in patients with heparin-induced thrombocytopenia who were treated with recombinant hirudin (r-hirudin) for >/=5 days. METHODS AND RESULTS The IgA, IgE, IgG, and IgM isotypes of anti-hirudin antibodies were determined by ELI...

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Comparison of Hirudin and Heparin

Recombinant desulfatohirudin (HI), a potent and specific thrombin inhibitor, was compared with heparin (HE) as an adjunct to streptokinase thrombolysis. In pentobarbital-anesthetized dogs, an occlusive thrombus (whole blood+thrombin) was introduced into the left anterior descending coronary artery (LAD) with superimposed endothelial damage and distal high-grade stenosis. Intravenous infusion of...

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Evaluation of the inhibition by heparin and hirudin of coagulation activation during r-tPA-induced thrombolysis.

Thrombin bound to a fibrin clot remains active and poorly accessible to heparin-AT III complex. During fibrinolysis, thrombin is released as thrombin-FDP complex and is inactivated by heparin-AT III. However, as successive fibrin layers are removed, inaccessible molecules of thrombin are exposed at the surface of the residual clot, possibly contributing to the occurrence during thrombolytic the...

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Treatment of an acute flush reaction caused by subcutaneous r-hirudin with pegylated hirudin.

We report a patient who was treated with recombinant (r)-hirudin for heparin-induced thrombocytopenia and developed a flush reaction twice upon re-exposure to 25 mg of subcutaneous r-hirudin. Antihirudin IgG antibodies developed. The patient received 50 mg of PEG-hirudin subcutaneously over 2 days. No side-effects occurred. The level of IgG antihirudin antibodies increased. Ecarin clotting time...

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Lepirudin (Recombinant Hirudin) for Parenteral Anticoagulation in Patients With Heparin-Induced Thrombocytopenia

Background—We prospectively investigated lepirudin for further parenteral anticoagulation in patients with heparininduced thrombocytopenia (HIT). Methods and Results—Patients with confirmed HIT (n5112) received lepirudin according to need for 2 to 10 days (longer if necessary): A1, treatment: 0.4 mg/kg IV bolus, followed by 0.15 mg z kg z h intravenous infusion, n565; A2, treatment in conjuncti...

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ژورنال

عنوان ژورنال: Circulation

سال: 1999

ISSN: 0009-7322,1524-4539

DOI: 10.1161/01.cir.100.14.1528