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2017 ; 129
(21
): 2864-2872
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Heparin-induced thrombocytopenia
#MMPMID28416511
Arepally GM
Blood
2017[May]; 129
(21
): 2864-2872
PMID28416511
show ga
Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin
therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin.
Pathogenic antibodies to PF4/heparin bind and activate cellular Fc?RIIA on
platelets and monocytes to propagate a hypercoagulable state culminating in
life-threatening thrombosis. It is now recognized that anti-PF4/heparin
antibodies develop commonly after heparin exposure, but only a subset of
sensitized patients progress to life-threatening complications of
thrombocytopenia and thrombosis. Recent scientific developments have clarified
mechanisms underlying PF4/heparin immunogenicity, disease susceptibility, and
clinical manifestations of disease. Insights from clinical and laboratory
findings have also been recently harnessed for disease prevention. This review
will summarize our current understanding of HIT by reviewing pathogenesis,
essential clinical and laboratory features, and management.