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Heparin-induced thrombocytopenia A contemporary clinical approach to diagnosis and management Shantsila E; Lip GYH; Chong BHChest 2009[Jun]; 135 (6): 1651-1664Thrombocytopenia following heparin administration can be associated with an immune reaction, now referred to as heparin-induced thrombocytopenia (HIT). HIT is essentially a prothrombotic disorder mediated by an IgG antiplatelet factor 4/heparin antibody, which induces platelet, endothelial cell, monocyte, and other cellular activation, leading to thrombin generation and thrombotic complications. Indeed, HIT can also be regarded as a serious adverse drug effect. Importantly, HIT can be a life-threatening and limb-threatening condition frequently associated with characteristically severe and extensive thromboembolism (both venous and arterial) rather than with bleeding. This article provides an overview of HIT, with an emphasis on the clinical diagnosis and management.|Anticoagulants/*adverse effects/therapeutic use[MESH]|Arginine/analogs & derivatives[MESH]|Chondroitin Sulfates/administration & dosage/adverse effects[MESH]|Dermatan Sulfate/administration & dosage/adverse effects[MESH]|Female[MESH]|Heparin/*adverse effects/therapeutic use[MESH]|Heparitin Sulfate/administration & dosage/adverse effects[MESH]|Hirudins/administration & dosage/adverse effects[MESH]|Humans[MESH]|Male[MESH]|Monitoring, Physiologic[MESH]|Peptide Fragments/administration & dosage/adverse effects[MESH]|Pipecolic Acids[MESH]|Platelet Aggregation Inhibitors/*administration & dosage/adverse effects[MESH]|Platelet Count[MESH]|Prognosis[MESH]|Randomized Controlled Trials as Topic[MESH]|Recombinant Proteins/administration & dosage/adverse effects[MESH]|Risk Factors[MESH]|Safety Management[MESH]|Severity of Illness Index[MESH]|Sulfonamides[MESH]|Survival Rate[MESH]|Thrombocytopenia/*chemically induced/diagnosis/drug therapy[MESH]|Thrombosis/drug therapy/prevention & control[MESH]|Time Factors[MESH] |
