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Heparin Treatment of Giant Hemangioma With Thrombocytopenia

David L. Benninghoff, MD; Leslie L. Alexander, MD; Mortimer M. Camiel, MD
JAMA. 1968;204(7):635. doi:10.1001/jama.1968.03140200075033.
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To the Editor:—  The report of Drs. Richardson and Smith (203:518, 1968) of successful heparin sodium therapy for a pregnant woman with thrombotic thrombocytopenia purpura (TTP) prompts this letter, suggesting the feasibility of heparin therapy for a different thrombocytopenic syndrome. Thrombocytopenia is an uncommon, but serious, sometimes lethal complication of giant hemangiomas of infancy. Since hemangiomas are malformations that as a rule involute spontaneously, no treatment is indicated. However, when thrombocytopenia or other deficits of coagulation factors occur, active treatment is required, consisting of local radiation, which usually results in rapid clinical improvement and eventual restoration of blood coagulation factors.Irradiation of infants is always cause for concern, however, so that alternative treatments ought to be weighed. Heparin therapy is promising for two reasons: (1) Heparin has been proven effective for the microangiopathies of which TTP is an example.1 (2) Giant hemangioma-thrombocytopenia syndrome may also be considered one

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