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Heparin-Induced Thrombocytopenia

Dureshahwar Ali, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • A potentially life-threatening complication of heparin use

    • Platelet count falls 50% or more from baseline.

    • 5-10% daily risk for thromboembolism, amputation, and death

  • Antibody-mediated ...

DIAGNOSIS

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

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

    • The foundation f...

TREATMENT

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

GENERAL MEASURES

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

1
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 A...

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 which is associated with arterial or venous thromboemboli...

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