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Correspondence
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Volume 359:1291-1293 September 18, 2008 Number 12
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Contaminated Heparin

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 by Kishimoto, T. K.
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To the Editor: Kishimoto et al. (June 5 issue)1 report that contamination of heparin with oversulfated chondroitin sulfate (OSCS) can induce anaphylactoid reactions through activation of the contact system. OSCS can also induce a clinical syndrome that is indistinguishable from immune heparin-induced thrombocytopenia,2 since the antigens are not heparin-specific but can be generated by other polysaccharides depending on the chain length and degree of sulfation.3 Hypersulfated polysaccharides behave as "super-heparins" in the induction of immune thrombocytopenia.2,3

Heparin-induced thrombocytopenia is relatively common and often consequential.4 At least 10 to 20% of affected patients die or have permanent sequelae such as stroke . . . [Full Text of this Article]


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