Chapter 20. Diagnosis and Management of Heparin-Induced Thrombocytopenia

  1. Mark A. Crowther MD, MSc, FRCPC Professor Division Director4,5,
  2. Jeff Ginsberg MD, FRCPC Professor6,
  3. Holger J. Schünemann MD, PhD, MSc, FACP, FCCP Professor7,8,
  4. Ralph M. Meyer MD, FRCPC Director Professor9,10 and
  5. Richard Lottenberg MD, FACP Professor11
  1. Theodore E. Warkentin MD, BSc(Med), FRCP(C), FACP1,2 and
  2. Andreas Greinacher3

Published Online: 4 FEB 2009

DOI: 10.1002/9781444300857.ch20

Evidence-Based Hematology

Evidence-Based Hematology

How to Cite

Warkentin, T. E. and Greinacher, A. (2009) Diagnosis and Management of Heparin-Induced Thrombocytopenia, in Evidence-Based Hematology (eds M. A. Crowther, J. Ginsberg, H. J. Schünemann, R. M. Meyer and R. Lottenberg), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444300857.ch20

Editor Information

  1. 4

    Division of Hematology, McMaster University, Hamilton, Ontario, Canada

  2. 5

    St. Joseph's Hospital, Hamilton, Ontario, Canada

  3. 6

    Department of Medicine, McMaster University, Hamilton, Canada

  4. 7

    CLARITY Research Group, Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy

  5. 8

    McMaster University, Hamilton, Canada

  6. 9

    National Cancer Institute of Canada, Clinical Trials Group, Edith Eisenhauer Chair in Clinical Cancer Research, Queen's University, Kingston, Ontario, Canada

  7. 10

    Departments of Oncology and Medicine, Queen's University, Kingston, Ontario, Canada

  8. 11

    Division of Hematology/Oncology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA

Author Information

  1. 1

    Department of Pathology and Molecular Medicine, Hamilton, Ontario, Canada

  2. 2

    Department of Medicine, McMaster University, Transfusion Medicine, Hamilton Regional Laboratory Medicine Program Service of Clinical Hematology, Hamilton, Ontario, Canada

  3. 3

    Department of Immunology and Transfusion Medicine and Transfusion Medicine, Thrombosis and Hemostasis Service, Universitätsklinikum Greifswald, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany

Publication History

  1. Published Online: 4 FEB 2009
  2. Published Print: 27 JUN 2008

ISBN Information

Print ISBN: 9781405157476

Online ISBN: 9781444300857

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Keywords:

  • Heparin-induced thrombocytopenia (HIT) - acquired, transient, prothrombotic disorder;
  • Heparin-Induced Thrombocytopenia;
  • alternative anticoagulants for treatment of thrombosis complicating HIT;
  • pretest probability of HIT - The “4 T's” scoring system;
  • alternative anticoagulants used to treat HIT;
  • warfarin (coumarin) anticoagulation - contraindicated during acute HIT;
  • natural history of isolated HIT?;
  • routine platelet count monitoring for HIT;
  • UFH - drug-of-choice for management of cardiac and vascular surgery with previous HIT

Summary

This chapter contains sections titled:

  • Introduction

  • What are the clinical features that suggest a diagnosis of HIT?

  • What laboratory tests are clinically useful for detecting HIT antibodies?

  • What alternative anticoagulants are efficacious for treatment of thrombosis complicating HIT?

  • Why is warfarin (coumarin) anticoagulation contraindicated during acute HIT?

  • What is the natural history of isolated HIT?

  • Can HIT be prevented?

  • Should routine platelet count monitoring for HIT be performed in some circumstances?

  • Is deliberate reexposure to heparin ever warranted in a patient with previous HIT?

  • References