Abstract
To the Editor:— In a recent report of the Council on Drugs inThe Journalof May 3, 1958, page 64, on protamine sulfate, N. F., no mention was made of the ineffectiveness of this agent in idiopathic or congenital hyperheparinemia. In a study of a patient with this condition (Am. J. M. Sc.234:251-258 [Sept.] 1957), Miss Hussey and I found that the intravenous injection of 50 mg. protamine sulfate actually increased the heparin titer and further prolonged the clotting time. It appears that protamine sulfate stimulates the output of heparin in the blood of this patient. In the test tube, on the contrary, the heparin in this patient's blood is neutralized either by protamine sulfate or toluidine blue as determined by the thrombin time test described in my monograph ( Hemorrhagic Diseases, Philadelphia, Lea & Febiger, 1957, page 431). During the two and a half years that his
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