Diagnosis and management of heparin‐induced thrombocytopenia: Third edition

Arachchillage, Deepa J.; Thachil, Jecko; Anderson, Julia A. M.; Baker, Peter; Poles, Anthony; Kitchen, Steve; Laffan, Mike; ,

doi:10.1111/bjh.19180

Cited by 7 publications

(1 citation statement)

References 143 publications

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“…According to the British Society of Haematology guidelines on the management of HIT, long‐term anticoagulation treatment is warfarin with target INR of 2–3, as DOAC cannot be used for arterial thrombosis [ 13 ]. Warfarin can be safely started once platelet count has normalised.…”

Section: Discussionmentioning

confidence: 99%

Plasma exchange and intravenous immunoglobulin for the peri‐operative management of type 2 heparin‐induced thrombocytopaenia in a patient requiring urgent surgery for critical limb ischaemia

Perera,

Taylor,

Bera

et al. 2024

Anaesthesia Reports

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SummaryWe report the case of a 61‐year‐old female who developed heparin‐induced thrombocytopaenia following treatment of a submassive pulmonary embolism, and who then required an above knee amputation for critical limb ischaemia. Heparin‐induced thrombocytopaenia is a rare, immune‐mediated complication associated with an in‐hospital mortality rate of 10%. It is more common in surgical patients, with patients undergoing orthopaedic surgery more likely to develop it than patients undergoing cardiac surgery, but heparin‐dependent immunoglobulin G antibodies are more likely to be formed in the latter. Peri‐operative management remains a challenge. Ideally, it is preferable to wait for the platelet count to improve; but in certain cases, surgery cannot be delayed. Heparin‐induced thrombocytopaenia is usually managed with direct thrombin inhibitors, such as argatroban and bivalirudin. Newer therapeutic modalities, such as plasmapheresis and intravenous immunoglobulin, as used in this case, can rapidly remove antibodies, but the certainty of evidence is low. Our case adds to the literature regarding the use of these modalities and highlights the multidisciplinary team approach required to manage such complex cases.

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Section: Discussionmentioning

confidence: 99%

Plasma exchange and intravenous immunoglobulin for the peri‐operative management of type 2 heparin‐induced thrombocytopaenia in a patient requiring urgent surgery for critical limb ischaemia

Perera,

Taylor,

Bera

et al. 2024

Anaesthesia Reports

View full text Add to dashboard Cite

show abstract

Challenges in the Monitoring of Therapeutic Plasma Exchange during Acute Heparin-Induced Thrombocytopenia in Adults under ECMO

Cavalie,

Gendron,

Kantor

et al. 2024

TH Open

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Anti‐platelet factor 4 immunothrombotic syndromes

Buka,

Pavord

2024

Br J Haematol

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Anti‐platelet factor 4 immunothrombotic syndromes comprise a group of disorders that include heparin‐induced thrombocytopenia and vaccine‐induced immune thrombocytopenia and thrombosis. These are highly prothrombotic, immunological disorders characterised by specific clinical and pathological criteria which include thrombocytopenia and thrombosis. While they are predominantly triggered by heparin and the adenoviral vector vaccines, respectively, other provoking factors have been described, as well as spontaneous forms. The unexplained co‐occurrence of thrombocytopenia with thrombosis should raise suspicion and prompt testing. This nutshell review discusses the pathophysiology, presenting features and diagnostic criteria for these conditions.

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Diagnosis and management of heparin‐induced thrombocytopenia: Third edition

Cited by 7 publications

References 143 publications

Plasma exchange and intravenous immunoglobulin for the peri‐operative management of type 2 heparin‐induced thrombocytopaenia in a patient requiring urgent surgery for critical limb ischaemia

Plasma exchange and intravenous immunoglobulin for the peri‐operative management of type 2 heparin‐induced thrombocytopaenia in a patient requiring urgent surgery for critical limb ischaemia

Challenges in the Monitoring of Therapeutic Plasma Exchange during Acute Heparin-Induced Thrombocytopenia in Adults under ECMO

Anti‐platelet factor 4 immunothrombotic syndromes

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