Heparin-Induced Thrombocytopenia

Tipsuda Junsanto-Bahri, MD and Maria A. Pino, PhD, MS, RpH Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Unexplained decrease in platelet count in a patient treated with heparin

    • ▪ Minimum platelet count falls between 30% and 50% from baseline.
  • Antibody-mediated prothrombotic disorder init...

DIAGNOSIS

  • Nonimmune heparin-associated thrombocytopenia (HIT): asymptomatic drop in platelet count

  • HITT: thrombocytopenia or thrombosis with the presence of heparin-dependent antibodies

    • ▪ The foundation...

TREATMENT

Treatment is by prompt withdrawal of heparin and replacement with a suitable alternative anticoagulant. 

GENERAL MEASURES

  • Discontinue all heparin products, including flushes and heparin-coated...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • The transition period of anticoagulation with a DTI and warfarin in patients with HIT can be problematic.

  • The INR while administering both a DTI and warfarin shoul...

REFERENCES

Salter  BS, Weiner  MM, Trinh  MA, et al. Heparin-induced thrombocytopenia: a comprehensive clinical review. J Am Coll Cardiol.  2016:67(21):2519–2522. [View Abstract on OvidInsights]

ADDITIONAL READING

  • Lo GK, Juhl D, Warkentin TE, et al. Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost. &#...

CODES

ICD10

D75.82 Heparin induced thrombocytopenia (HIT) 

ICD9

289.84 Heparin-induced thrombocytopenia (HIT) 

SNOMED

  • 73397007 Heparin-induced thrombocytopenia (disorder)

  • 111588002 Heparin-induced thrombocy...

CLINICAL PEARLS

  • Heparin exposure through virtually any preparation (including LMWH), any dose, or any route can cause HITT, a life-threatening condition which is associated with severe and extensive t...

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