title: Argatroban treatment for patients with intolerance to heparin and hirudin.
abstract: Argatroban is a synthetic thrombin inhibitor that acts independently of any cofactor. It inhibits free as well as fibrin- and clot-bound thrombin. The clinical history of two patients is presented, both with previous allergic reactions toward heparin and hirudin. In both patients, antibodies against hirudin were documented. Argatroban was successfully used in both patients without any side effects. We conclude argatroban to be the drug of choice in patients with intolerance to heparin and hirudin. Moreover, genetic variations affecting the hepatic catabolism of argatroban might exist, because very different dosages of argatroban were needed in the two patients.
authors.affiliation: Zentrum Innere Medizin der Universität Giessen, Germany. Bettina.Kemkes-Matthes@innere.med.uni-giessen.de
authors.forename: Bettina
authors.initials: B
authors.lastname: Kemkes-Matthes
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Walenga
authors.forename: Job
authors.initials: J
authors.lastname: Harenberg
authors.forename: Jawed
authors.initials: J
authors.lastname: Fareed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives; D000075202:Contraindications; D004342:Drug Hypersensitivity; D005260:Female; D006493:Heparin / Q000009:adverse effects; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D010875:Pipecolic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D013449:Sulfonamides
chemical_list: D006629:Hirudins; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban