A patient with a mast cell disorder may release enough heparin to develop clinical bleeding.
(1) mast cell disorder (localized or systemic)
(2) clinical bleeding disorder following mast cell activation
(3) prolonged aPTT or evidence of increased serum heparin
(4) absence of a bleeding disorder in the absence of mast cell activation
Protamine sulfate therapy may reverse the heparin effect. However, protamine sulfate may also activate mast cells, making the bleeding worse.
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Specialty: Hematology Oncology, Clinical Laboratory