Heparin-Induced Thrombocytopenia: Recognition, Treatment, and Prevention

Heparin-Induced Thrombocytopenia

“…Further, the cross-reactivity rate between heparin and LMWH is so high that LMWH is not recommended for the treatment of HIT patients (Chong, 2003;Warkentin et al, 2008a). Alternative anticoagulant therapy must be initiated immediately, both for HIT patients diagnosed with thrombocytopenia alone or with thromboembolism (Warkentin & Greinacher, 2004). In patients in whom treatment was delayed until an HIT diagnosis could be confirmed by laboratory tests, the incidence of new thrombosis was approximately 10-fold higher than in individuals treated promptly with a direct thrombin inhibitor (Greinacher et al, 2000).…”

Heparin-induced Thrombocytopenia in the ICU: An Overview

“…Alternative therapeutic anticoagulation should be initiated based on a high clinical suspicion and not delayed while awaiting confi rmatory laboratory testing or because of thrombocytopenia [39]. When treatment was delayed pending laboratory confi rmation of the diagnosis within a clinical trial setting, the incidence of new thrombosis was approximately tenfold higher than during the subsequent period of treatment with a direct thrombin inhibitor [40].…”

“…In these patients, vitamin K antagonist therapy may induce lower limb venous gangrene or severe skin necrosis. Th is occurs a few days after the onset of vitamin K antagonist therapy [39,51]. Treatment with vitamin K antagonists is asso ciated with a rapid decrease in protein C concentration, which has a short half-life of 6 hours, whereas serum levels of procoagulant coagulation factors (Factors II, VII, IX, X) remain high during the fi rst days of therapy.…”

“…Alternative anticoagulants should be used during thrombocytopenia and should be continued until the platelet count has reached a stable plateau and the international normalized ratio (INR) has reached the intended target range, with a minimal overlap of 5 days [14,16]. For patients receiving a vitamin K antagonist at the time of diagnosis of HIT, use of vitamin K is recommended [16,39,51].…”

Fondaparinux treatment in heparin induced thrombocytopenia:a case report

“…Bu nedenle heparin tedavisinin dördüncü günden itibaren 2-3 günde bir trombosit sayısının ölçülmesi gerekmektedir (6). Diğer yandan HBT klinik pratikte oldukça nadir karşılaşılan bir durum olduğundan hekimler bu konuda yeterli deneyime sahip değildir.…”