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  Vol. 168 No. 19, October 27, 2008 TABLE OF CONTENTS
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COMMENTS AND OPINIONS
Incidence and Prognostic Significance of Thrombocytopenia in Patients Receiving Heparin Therapy

Weekitt Kittisupamongkol, MD

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I read the recent article by Oliveira et al1 with interest. There are a few questions in my mind. First, the authors rely on automated platelet counts but ignore peripheral blood smear. This would lead to the inclusion of pseudothrombocytopenia, a condition of platelet clumping associated with blood collected in EDTA tubes.2 Second, a significant proportion of the enrolled patients are elderly with premorbid conditions.1 Some of them are likely to receive several medications. While their exclusion criteria include only those receiving antineoplastic agents known to affect bone marrow, concomitant use of potential inducers of thrombocytopenia,3 including antimicrobials, analgesics, anticonvulsants, and thiazide diuretics, might contribute to the reported thrombocytopenia.

Last but not least, heparin-induced thrombocytopenia in this study is type II, the more sinister form. The benign form, or type I, occurs within 4 days of therapy and rarely causes platelet count to go below 100 x. . . [Full Text of this Article]


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