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Heparin-Induced Thrombocytopenia

Caleb J. Mentzer, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A severe complication of heparin use that can cause serious morbidity and mortality

    • Platelet count falls greater than 30% at least 4 days following heparin exposure

    • Mortality risk up t...

DIAGNOSIS

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

  • Heparin induced thrombocytopenia with thrombosis (HITT): thrombocytopenia or thrombosis with the prese...

TREATMENT

Treatment is by prompt discontinuation of heparin and replacement with an alternative anticoagulant. Low molecular weight heparin (LMWH) is NOT indicated in the treatment of HIT. 

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

  • The INR while on both a DTI and warfarin should be therapeutic (...

REFERENCES

1
Cuker A, Arepally GM, Chong B, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood Adv.2018;2(22):3360–3...

CODES

ICD10

D75.82 Heparin induced thrombocytopenia (HIT) 

SNOMED

  • 73397007 Heparin-induced thrombocytopenia (disorder)

  • 111588002 Heparin-induced thrombocytopenia with thrombosis (disorder)

CLINICAL PEARLS

  • Heparin exposure through any preparation (including LMWH), any dose, or any route can cause HITT, a life-threatening condition associated with arterial or venous thromboembolic complic...

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