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Heparin-Induced Thrombocytopenia

Tipsuda Junsanto-Bahri, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • A life-threatening complication of heparin use

    • Platelet count falls between 30% and 50% from baseline.

  • Antibody-mediated prothrombotic disorder initiated by heparin administration

  • Unlik...

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 withdrawal of heparin and replacement with a suitable alternative anticoagulant. 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):2519–2532.
2
Cuker A, Arepally G, Crowther MA, ...

ADDITIONAL READING

  • Chaudhary RK, Nepal C, Khanal N, et al. Management and outcome of heparin-induced thrombocytopenia in pregnancy: a systematic review. Cardiovasc Hematol Agents Med Chem.  2015;...

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 any preparation (including LMWH), any dose, or any route can cause HITT, a life-threatening condition that is associated with severe and extensive thromboembol...

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