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Heparin-Induced Thrombocytopenia

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Abstract

Heparin-induced thrombocytopenia (HIT) is an uncommon condition with grave consequences. It is a clinicopathological diagnosis which can often be complex. However, delayed diagnosis and inadequate or inappropriate treatment can lead to life- and limb-threatening outcomes. This chapter will describe the syndrome of HIT (and HITT—heparin-induced thrombocytopenia with thrombosis) as it is now known, including its history, pathophysiology, diagnostic process with the current testing paradigm, and updated treatment options for HIT.

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Abbreviations

ACCP:

American College of Chest Physicians

ACT:

Activated clotting time

CFX:

Chromogenic factor X

CPB:

Cardiopulmonary bypass

DOAC:

Direct oral anticoagulants

DTI:

Direct thrombin inhibitor

DVT:

Deep vein thrombosis

ELISA:

Enzyme-linked immunosorbent assay

HAT:

Heparin-associated thrombocytopenia

HEP:

HIT Expert Probability

HIT:

Heparin-induced thrombocytopenia

INR:

International normalized ratio

IVC:

Inferior vena cava

LMWH:

Low-molecular-weight heparin

O.D.:

Optical density

PaGIA:

Particle gel immunoassay

PCI:

Percutaneous coronary intervention

PE:

Pulmonary embolism

PF4:

Platelet factor 4

SRA:

Serotonin release assay

VKA:

Vitamin K antagonist

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Authors and Affiliations

  1. Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Virginia Medical Center, University of Virginia, Charlottesville, VA, USA

    Emily Downs

  2. Department of Pharmacy, University of Virginia Medical Center, University of Virginia, Charlottesville, VA, USA

    Svetlana Goldman & Surabhi Palkimas

  3. Department of Medicine, Cardiovascular Medicine Division, Heart and Vascular Center, University of Virginia Medical Center, University of Virginia, Charlottesville, VA, USA

    Aditya M. Sharma

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  1. Emily Downs
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  2. Svetlana Goldman
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  4. Aditya M. Sharma
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Correspondence to Aditya M. Sharma .

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Editors and Affiliations

  1. Associate Professor of Cardiology, Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Manhasset, New York, USA

    Joe F. Lau

  2. Assistant Professor, Division of Internal Medicine, Frankel Cardiovascular Center at the University of Michigan, Ann Arbor, Michigan, USA

    Geoffrey D. Barnes

  3. Professor of Medicine and Pathology, Division of Hematology, Department of Medicine, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA

    Michael B. Streiff

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Downs, E., Goldman, S., Palkimas, S., Sharma, A.M. (2018). Heparin-Induced Thrombocytopenia. In: Lau, J., Barnes, G., Streiff, M. (eds) Anticoagulation Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-73709-6_17

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