Heparin induced thrombocytopenia
Authors:
J. Novotný; M. Penka
Authors‘ workplace:
Oddělení klinické hematologie, FN Brno
Published in:
Transfuze Hematol. dnes,27, 2021, No. 1, p. 9-15.
Category:
Review/Educational Papers
doi:
https://doi.org/10.48095/cctahd20219
Overview
Heparin induced thrombocytopenia (HIT) represents a very serious complication of heparin therapy associated with high morbidity and/or mortality. HIT is caused by generation of antibodies against macromolecular complexes of heparin/platelet factor 4 resulting in activation of platelets, monocytes, endothelium and neutrophils with subsequent high thrombin generation and induction of a hypercoagulable state. Therapy with heparins must be interrupted and alternative non-heparin antithrombotics must be introduced. The diagnosis of HIT is based on clinical findings namely the so called 4T score and laboratory tests. Immunological tests have a high negative predictive value in excluding HIT. In positive cases, the diagnosis must be confirmed by functional tests. Novel developments in the therapy of HIT include the introduction of the new direct oral anticoagulants.
Keywords:
heparin induced thrombocytopenia – thrombosis – non-heparin anticoagulants – direct oral anticoagulants – DOACs
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