RT Journal
A1 STEIN ZG
T1 HEparin and antithrombin 3
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD August 1
VO 114
IS 8
SP 980
OP 980
DO 10.1001/archsurg.1979.01370320112029
UL http://dx.doi.org/10.1001/archsurg.1979.01370320112029
AB To the Editor.—The white clot syndrome recently reported by Towne et al1 is disturbing. The complications of therapy with heparin are a problem not only for physician and patient, but for the clinical pharmacist, who is often called on to explain them. Another problem of therapy with heparin that can result in thromboembolic sequelae is a heparin-induced decrease in levels of antithrombin 3. Antithrombin 3 is believed necessary for heparin's antithrombic effects and, paradoxically, in some patients, heparin causes a reduction in the level of this factor.2 Towne and his fellow workers made no mention of this and one wonders if reduction in the levels of antithrombin 3 could have been an aggrevating factor. Although the thrombi were of arterial origin where platelet aggregation is believed to be of greater importance than the intrinsic coagulation system, a heparininduced depletion of antithrombin 3 may have contributed to the