white clot syndrome

white clot syndrome

 
a complication of heparin therapy characterized by intravascular clots composed of platelet aggregates. In some sensitive individuals heparin stimulates formation of antibody to the person's own platelets; the antigen-antibody reaction causes clumping of the affected cells and formation of a clot. Platelet clots can affect blood vessels anywhere in the body and lead to such conditions as gangrene of a limb, stroke, and myocardial infarction.

Treatment. Treatment is intended to reverse thrombocytopenia and eliminate sources of heparin in the blood. Heparin administration is stopped as soon as a white clot syndrome is suspected, and all traces of heparin are flushed from the intravenous line. Once a history of white clot syndrome is known, heparin therapy is prohibited, as it can precipitate a reaction months after a person is initially sensitized to heparin.
Patient Care. Prevention of white clot syndrome includes asking all patients about sensitivity to heparin during the initial assessment and scheduling platelet counts every 2 to 3 days during the course of heparin therapy. Patients on heparin should be monitored periodically for pain in the chest or extremities, diminishing pulse, or signs of cerebral ischemia. Additionally, the patient with heparin sensitivity should be taught the nature of the syndrome and its symptoms and encouraged to wear some form of identification or otherwise inform all health care providers of the sensitivity to heparin.