TY - JOUR
T1 - Heparin-induced thrombocytopenia (HIT)
T2 - Review of incidence, diagnosis, and management
AU - Hogan, Marie
AU - Berger, Jeffrey S.
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening complication of heparin exposure. Here, we review the pathogenesis, incidence, diagnosis, and management of HIT. The first step in thwarting devastating complications from this entity is to maintain a high index of clinical suspicion, followed by an accurate clinical scoring assessment using the 4Ts. Next, appropriate stepwise laboratory testing must be undertaken in order to rule out HIT or establish the diagnosis. In the interim, all heparin must be stopped immediately, and the patient administered alternative anticoagulation. Here we review alternative anticoagulation choice, therapy alternatives in the difficult-to-manage patient with HIT, and the problem of overdiagnosis.
AB - Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening complication of heparin exposure. Here, we review the pathogenesis, incidence, diagnosis, and management of HIT. The first step in thwarting devastating complications from this entity is to maintain a high index of clinical suspicion, followed by an accurate clinical scoring assessment using the 4Ts. Next, appropriate stepwise laboratory testing must be undertaken in order to rule out HIT or establish the diagnosis. In the interim, all heparin must be stopped immediately, and the patient administered alternative anticoagulation. Here we review alternative anticoagulation choice, therapy alternatives in the difficult-to-manage patient with HIT, and the problem of overdiagnosis.
KW - heparin-induced thrombocytopenia (HIT)
KW - hypercoagulable states
KW - venous thromboembolism (VTE)
UR - http://www.scopus.com/inward/record.url?scp=85082675669&partnerID=8YFLogxK
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U2 - 10.1177/1358863X19898253
DO - 10.1177/1358863X19898253
M3 - Article
C2 - 32195628
AN - SCOPUS:85082675669
SN - 1358-863X
VL - 25
SP - 160
EP - 173
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
IS - 2
ER -