|
福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.64 (2018) >
このアイテムの引用には次の識別子を使用してください:
http://ir.fmu.ac.jp/dspace/handle/123456789/672
|
| タイトル: | Induction of anti-PF4/heparin antibodies after arthroplasty for rheumatic diseases |
| 著者: | Migita, Kiyoshi
Asano, Tomoyuki
Sato, Shuzo
Motokawa, Satoru |
| 学内所属: | リウマチ膠原病内科学講座 |
| 誌名/書名: | Fukushima Journal of Medical Science |
| 巻: | 64 |
| 号: | 1 |
| 開始ページ: | 1 |
| 終了ページ: | 8 |
| 発行日: | 2018年 |
| 抄録: | Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. These pathogenic antibodies against PF4/heparin bind and activate cellular FcγRIIa on platelets to induce a hypercoagulable state culminating in thrombosis. Recent studies indicate several conditions, including joint surgery, induce spontaneous HIT, which can occur without exposure to heparin. To determine the real-world evidences concerning the incidences of venous thromboembolism (VTE) after total joint arthroplasty for rheumatic disease, we conducted a multicenter cohort study (J-PSVT) designed to document the VTE and seroconversion rates of anti-PF4/heparin antibody in 34 Japanese National hospital organization (NHO) hospitals. J-PSVT indicated that prophylaxis with fondaparinux, not enoxaparin, reduces the risk of deep vein thrombosis in patients undergoing arthroplasty. Multivariate analysis revealed that dynamic mechanical thromboprophylaxis (intermittent plantar device) was an independent risk factor for seroconversion of anti-PF4/heparin antibodies, which was also confirmed by propensity-score matching. Seroconversion rates of anti-PF4/heparin antibodies were significantly reduced in rheumatoid arthritis (RA) patients compared with osteoarthritis (OA) patients, which may link with the findings that IgG fractions isolated from RA patients not OA patients contained PF4. Our study indicated that a unique profile of anti-PF4/heparin antibodies is induced by arthroplasty for rheumatic diseases. |
| 出版者: | The Fukushima Society of Medical Science |
| 出版者（異表記）: | 福島医学会 |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/672 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/672/1/FksmJMedSci_64_p1.pdf |
| ISSN: | 0016-2590
2185-4610 |
| DOI: | 10.5387/fms.2018-06 |
| PubMed番号: | 29628468 |
| 関連ページ: | https://doi.org/10.5387/fms.2018-06 |
| 権利情報: | © 2018 The Fukushima Society of Medical Science |
| 出現コレクション: | Vol.64 (2018)
|
このリポジトリに保管されているアイテムは、他に指定されている場合を除き、著作権により保護されています。
|
