PB0708 - Heparin-induced thrombocytopenia among patients with end-stage renal disease in Gombe, Nigeria

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Saleh Yuguda, MBBS, FMCPath

Professor/Consultant Haematologist
Gombe State University/Federal Teaching Hospital Gombe
Gombe, Gombe, Nigeria

Co-Author(s)

AM

Aisha Mohammed Umar

Senior Registrar/Lecturer II
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria
KM

Kasim Mohammed Pindiga

Consultant Haematologist/Senior Lecturer
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria
AI

Ahmed Iya Girei

Consultant Haematologist/Reader
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria
AI

Ahmad Idris

Registrar
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria
IO

Isma'il Omeiza Sanni

Consultant Nephrologist
Federal Teaching Hospital Gombe
Gombe, Gombe, Nigeria
SA

Sani Adamu

Consultant Chemical Pathologist/Professor
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria

Background: Heparin-induced thrombocytopenia (HIT) is an immune mediated complication of heparin therapy that is characterized by the development of platelet-activating antibodies that target the platelet factor 4 (PF4)–heparin complexes, leading to a decline in platelets and subsequent development of thrombosis in extreme cases. The thrombocytopenia in HIT is defined as a fall in platelets count of >50% 5 or more days after starting heparin treatment or earlier if heparin has been given previously. Patients with end-stage renal disease [(ESRD) (GFR < 15mL/min/1.73m2) are exposed to heparins during haemodialysis (HD) and are therefore at risk of development of HIT.

Aims: To evaluate heparin-induced thrombocytopenia in patients with ESRD undergoing HD.

Methods: This is a retrospective review of platelets counts in patients with ESRD undergoing HD at the Federal Teaching Hospital Gombe, Nigeria. The baseline platelets counts were compared with a repeat one after commencement of HD.

Results: A total of 42 patients with ESRD were included out of which 59.5% were males. The age range was 25 to 99 years with a mean of 50 (±15.5) years. The eGFR range of the participants was 1.2 – 14.1 mL/min/1.73m2 with a mean of 5.9 (±3.0) mL/min/1.73m2. The mean pre-dialysis platelets count was 283.3 x 109/dL while the mean post-dialysis count was 229.1 x 109/dL. Five patients (11.9%) had platelets count drop of >50%. There is no statistically significant difference in sex distribution among patients with platelets drop of >50% (males 60% vs females 40%). None of the patients above 60 years of age is affected and also, none developed thrombosis.

Conclusion(s): This study shows that a significant percentage (11.9%) of patients developed >50% drop in platelets count. Though PF4 assay not done, we believe that this will serve as a baseline data on the prevalence of HIT in ESRD.