Hyperheparinemia: Cause of the Hemorrhagic Syndrome Associated With Total Body Exposure to Ionizing Radiation

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Abstract
Hemorrhage is one of the most striking features of the syndrome which follows acute whole-body exposure to ionizing radiations in the midlethal range. The disease is accompanied by a thrombocytopenia. Observations are presented to show that the most significant cause of the hemorrhages is an increased amt. of free heparin in the blood. (1) The clotting time may be greatly prolonged or the blood made incoagulable after acute exposure to ionizing radiations delivered over the entire body. If clotting time is sufficiently prolonged, the blood of an irradiated dog will delay the clotting time of normal blood, indicating the presence of an active anticoagulant not normally present in blood. (2) There is evidence that the anticoagulant is heparin. Specific antiheparin substances will return the clotting time to normal. These substances will prevent or stop hemorrhage even though the platelet count may be less than 50,000. (3) An anticoagulant indistinguishable from heparin was isolated from the blood of irradiated dogs. (4) Thrombocytopenia per se was not important in the development of hemorrhage because they both always occurred in the same animal, the time of onset of each varied considerably and did not always coincide. When the dye was given, bleeding was controlled, but the platelet count, if reduced, was not raised. (5) Vit. K, ascorbic acid, Ca salts, and whole blood transfusions did not prevent hemorrhage or stop bleeding once it occurred.

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