Skip to main content
Log in

Adverse effects of three different forms of heparin therapy: thrombocytopenia, increased transaminases, and hyperkalaemia

  • Short Communications
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

A prospective study has been made of the incidence of changes in transaminase levels, hyperkalaemia and thrombocytopenia in three groups of patients: 89 consecutive patients with venous thrombosis receiving therapeutic heparinization, 49 patients admitted because of hip fracture and receiving prophylactic low-dose conventional heparin, and 43 patients admitted because of hip fracture and randomly allocated to receive low molecular weight heparin.

Laboratory measurements were made on admission and 8 days after commencing heparin. Only two patients on high-dose heparin developed thrombocytopenia. Increased transaminases were frequent with conventional heparin (18% and 32% of patients on high-dose heparin developed abnormal AsT and AlT values, respectively compared with 14% and 17% patients on low dose therapy). In contrast, only one patient on low molecular weight heparin developed abnormal AlT activity. Hyperkalaemia was uncommon in patients on any form of heparin therapy, and severe hyperkalaemia occurred in only one patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. White PW, Saad JR, Nensel RE (1979) Thrombotic complications of heparin therapy. Ann Surg 190: 595–608

    Google Scholar 

  2. Powers PJ, Kelton JG, Carter CJ (1984) Studies on the frequency of heparin-associated thrombocytopenia. Thromb Res 33: 439–443

    Google Scholar 

  3. King DJ, Kelton JG (1984) Heparin-associated thrombocytopenia. Ann Intern Med 100: 535–540

    Google Scholar 

  4. Stead RB, Schafer AI, Rosenber RD, Handin RI, Josa M, Khuri SF (1984) Heterogeneity of heparin lots associated with thrombocytopenia and thromboembolism. Am J Med 77: 185–188

    Google Scholar 

  5. Nelson JC, Lerner RG, Goldstein R, Cagin NA (1978) Heparin-induced thrombocytopenia. Arch Intern Med 138: 548–552

    Google Scholar 

  6. Olsson R, Korsan-Bengstein BM, Korsan-Bengstein K, Lennartsson J, Waldestrom J (1978) Serum aminotransferases after low-dose heparin treatment. Acta Med Scand 204: 229–230

    Google Scholar 

  7. Minar E, Ehringer H, Hirschl M (1980) Transaminasenanstieg: eine weitgehend unbekannte Nebenwirkung der Heparintherapie. Dstch Med Wochenschr 105: 1713–1717

    Google Scholar 

  8. Dukes GE, Sanders SW, Russo J, Swenson E, Burnakis TG, Saffle JR, Warden GD (1984) Transaminase elevations in patients receiving bovine or porcine heparin. Ann Intern Med 100: 646–650

    Google Scholar 

  9. Edes TE, Sunderrajan EV (1985) Heparin-induced hyperkalemia. Arch Intern Med 145: 1070–1072

    Google Scholar 

  10. Phelps KR, Oh MS, Carroll HJ (1980) Heparin-induced hyperkalaemia: Report of a case. Nephron 25: 254–258

    Google Scholar 

  11. Leehey D, Ganti C, Lim V (1981) Heparin-induced hypoaldosteronism. J Am Med Assoc 246: 2189–2190

    Google Scholar 

  12. Roussi JH, Houbouyan LL, Goguel AF (1984) Use of low-molecular weight heparin in heparin-induced thrombocytopenia with thrombotic complications Lancet 1: 1183

    Google Scholar 

  13. Rao J, Pelavin MH, Morgenstern S (1973) SMAC: High-speed continuous-flow, ion-selective electrode for sodium and potassium: Theory and design. In: Advances in automated analysis. Technicon International Congress, vol I: Clinical chemistry methods. Mediad Inc., Tarrytown New York, pp 33–36

    Google Scholar 

  14. Vanko M, Meola J (1973) SMAC: Sodium ion-selective electrode: A preliminary evaluation. In: Advances in automated analysis. Technicon International Congress 1972, vol I: Clinical chemistry methods. Mediad Inc., Tarrytown New York, pp 37–39

    Google Scholar 

  15. Pioda LAR, Siman W, Bosshard HR, Curtius HC (1970) Determination of potassium ion concentration in serum using a highly selective liquid-membrane electrode. Clin Chim Acta 29: 289–293

    Google Scholar 

  16. Henry RJ, Chiamori N, Golub OJ, Berkman S (1960) Revised spectrophotometric methods for the determination of glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase and lactic acid dehydrogenase. Tech Bull Reg Med Tech 30: 149–166

    Google Scholar 

  17. Bergqvist D (1983) Low-dose heparin. In: Bergqvist D (ed) Postoperative thromboembolism. Frequency, etiology, prophylaxis. Springer-Verlag, Berlin Heidelberg New York, pp 89–112

    Google Scholar 

  18. Rhodes GR, Dixon RH, Silver D (1977) Heparin-induced thrombocytopenia. Eight cases with thrombotic-haemorrhagic complications. Ann Surg 186: 752–756

    Google Scholar 

  19. Bergqvist D, Burmark US, Frisell J, Hallböök T, Lindblad B, Risberg B, Törngren S, Wallin G (1986) Prospective double-blind comparison between Fragmin and conventional low-dose heparin: Thromboprophylactic effect and bleeding complications. Haemostasis 16 [Suppl 2]: 11–18

    Google Scholar 

  20. Lockner D, Bratt G, Törnebohm E, Aberg W, Granqvist S (1986) Intravenous and subcutaneous administration of fragmin in deep venous thrombosis. Haemostasis 16 [Suppl 2]: 25–29

    Google Scholar 

  21. Holm HA, Ly B, Handeland GF, Abilgaard U, Arnesen KE, Gottschalk P, Hoeg V, Aandahl M, Haugen K, Laerum F, Scheel B, Sortland O, Vinje B (1986) Subcutaneous heparin treatment of deep venous thrombosis: A comparison of unfractioned and low molecular weight heparin. Haemostasis 16 [Suppl 2]: 30–37

    Google Scholar 

  22. Palmieri G, Ambrosi G, Agrati AM, Ferraro G, Marcozzi S (1988) A new low molecular weight heparin in the treatment of peripheral artery disease. Int Angiol 7 [Suppl 3]: 41–47

    Google Scholar 

  23. Wilson ID, Goetz FC (1964) Selective hypoaldosteronism after prolonged heparin administration. Am J Med 36: 635–640

    Google Scholar 

  24. O'Kelly R, Magee F, McKenna TJ (1983) Routine heparin therapy inhibits adrenal aldosterone production. J Clin Endocrinol Metab 56: 108–112

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Monreal, M., Lafoz, E., Salvador, R. et al. Adverse effects of three different forms of heparin therapy: thrombocytopenia, increased transaminases, and hyperkalaemia. Eur J Clin Pharmacol 37, 415–418 (1989). https://doi.org/10.1007/BF00558513

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00558513

Key words

Navigation