Low-molecular weight heparin (LMWH) is associated with a lower incidence of heparin-induced thrombocytopenia (HIT) than is unfractionated heparin. We describe a 75-year-old woman who developed HIT with thrombotic manifestations following the use of nadroparin calcium. Subsequent anticoagulation was achieved with warfarin. This case serves to highlight an important complication that cannot be ignored despite its low incidence. The majority of HIT cases are likely to occur in LMWH-treated patients because LMWH replaces unfractionated heparin for most indications. The lack of suitable alternative anticoagulant treatments for patients with HIT in Singapore is also emphasized. Int J Hematol.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
King DJ, Kelton JG. Heparin-associated thrombocytopenia.Ann Intern Med. 1984;100:535–540.
Warkentin TE, Kelton JG. Hcparin-induced thrombocytopenia.Prog Hemost Thromb. 1991;10:1–34.
Chong BH, Fawaz I, Chesterman CN, Berndt MC. Heparin-induced thrombocytopenia: mechanism of interaction of the heparin-dependent antibody with platelets.Br J Haematol. 1989;73:235–240.
Kelton JG, Smith JW, Warkentin TE, Hayward CPM, Denomme GA, Horsewood P. Immunoglobulin G from patients with heparin-induced thrombocytopenia binds to a complex of heparin and platelet factor 4.Blood. 1994;83:3232–3239.
Warkentin TE, Hayward CPM, Boshkov LK, et al. Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of the heparin-induced thrombocytopenia.Blood. 1994;84:3691–3699.
Laster J, Elfrink R, Silver D. Reexposure to heparin of patients with heparin-associated antibodies.J Vasc Surg. 1989;9:677–682.
Warkentin TE, Kelton JG. Temporal aspects of heparin-induced thrombocytopenia.N Engl J Med. 2001;344:1286–1292.
Chong BH, Castaldi PA. Platelet proaggregating effect of heparin: possible mechanism for non-immune heparin-associated thrombocytopenia.Aust N Z Med. 1986;16:715–716.
Warkentin TE, Levine MN, Hirsch J, et al. Heparin-induced thrombocytopenia in patients treated with low molecular weight heparin or unfractionated heparin.N Engl J Med. 1995;332:1330–1335.
Demasi R, Bode AP, Knupp C, Bogey W, Powell S. Heparininduced thrombocytopenia.Am Surg. 1994;60:26–29.
Schmitt BP, Adelman B. Heparin-associated thrombocytopenia: a critical review and pooled analysis.Am J Med Sci. 1993;305:208–215.
Warkentin TE, Chong BH, Greinacher A. Heparin-induced thrombocytopenia: toward consensus.Thromb Haemost. 1998;79:1–7.
Warkentin TE, Kelton JG. A 14-year study of heparin-induced thrombocytopenia.Am J Med. 1996;101:502–507.
Kelton JG. The clinical management of heparin-induced thrombocytopenia.Semin Hematol. 1999;36:17–21.
Potzsch B, Unkrig C, Madlener K. APC resistance and early onset of oral anticoagulation are high thrombotic risk factors in patients with heparin-associated thrombocytopenia (HAT).Ann Hematol. 1996;72(suppl 1):A6.
About this article
Cite this article
Ng, H.J., Lee, L.H. Heparin-Induced Thrombocytopenia: Acknowledging Its Presence in Low-Molecular Weight Heparin Therapy. Int J Hematol 77, 185–187 (2003). https://doi.org/10.1007/BF02983219
- Low incidence