Heparin-induced thrombocytopenia: some working hypotheses on pathogenesis, diagnostic strategies and treatment

2008 ◽  
Vol 7 (6) ◽  
pp. 577-585
Author(s):  
Lorenzo Alberio
Keyword(s):  
Heparin Induced Thrombocytopenia ◽  
Diagnostic Strategies ◽  
Working Hypotheses

scholarly journals Heparin-induced thrombocytopenia: research and clinical updates

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 262-268 ◽  
Author(s):  
Oluwatoyosi Onwuemene ◽  
Gowthami M. Arepally
Keyword(s):  
Limited Data ◽  
Platelet Factor ◽  
Heparin Induced Thrombocytopenia ◽  
Diagnostic Strategies ◽  
Immune Mediated ◽  
Emerging Therapies ◽  
Current Perspective ◽  
Clinical Advances ◽  
A Current

Abstract Heparin-induced thrombocytopenia (HIT) remains an important diagnosis to consider in hospitalized patients developing thrombocytopenia. HIT is an immune-mediated prothrombotic disorder caused by antibodies to platelet factor 4 (PF4) and heparin. Recent basic scientific studies have advanced our understanding of disease pathogenesis through studies of the PF4/heparin structure, immune mechanisms, and cellular basis of thrombosis. Clinical advances have also occurred in areas of HIT prevention, description of disease variants, and diagnostic strategies. Emerging anticoagulants with the potential to change HIT treatment are evolving, although with limited data. This review will provide a current perspective on HIT pathogenesis, disease features, diagnostic strategies, and role of emerging therapies for the management of HIT.

A clinical-laboratory algorithm incorporating optical density value to predict heparin-induced thrombocytopenia

2011 ◽  
Vol 105 (03) ◽  
pp. 553-559 ◽  
Author(s):  
Eric Bensadoun ◽  
George Davis ◽  
Jeremy Flynn ◽  
Daniel Lewis ◽  
Kathryn Ruf
Keyword(s):  
Optical Density ◽  
Clinical Laboratory ◽  
Diagnostic Algorithm ◽  
Serotonin Release ◽  
Thrombin Inhibitor ◽  
Laboratory Findings ◽  
Heparin Induced Thrombocytopenia ◽  
Diagnostic Strategies ◽  
Specificity And Sensitivity ◽  
4T Score

SummaryThe diagnosis of heparin-induced thrombocytopenia (HIT) is complex and involves integrating both clinical and laboratory findings. Readily available diagnostic tests such as the heparin-dependant antibody assay (HDAA) lack desired specificity when utilised alone. A diagnostic algorithm incorporating the 4T pretest probability score, HDAA, and optical density (OD) value was implemented as a tool to assist in the diagnosis of HIT and with the decision to treat patients. Patients with a 4T score >3 and/or positive HDAA result with an OD ≥1 were considered positive. Utilisation of this algorithm was hypothesised to improve the identification of patients without SRA confirmed HIT and improve overall specificity compared to other diagnostic strategies. Retrospective chart review was conducted and included patients with a positive or equivocal HDAA result and a serotonin release assay result during a two-year period. Each patient was evaluated for the diagnosis of HIT using the algorithm. The specificity and sensitivity of the diagnostic algorithm to identify subjects with SRA confirmed HIT was evaluated. A total of 83 patients were identified for inclusion in the study. The diagnostic algorithm identified 22 patients for direct thrombin inhibitor (DTI) therapy. Nine of these patients were SRA positive. The sensitivity of the algorithm was 0.9 with a specificity of 0.822. The diagnostic algorithm was found to be both more specific and sensitive than other diagnostic strategies including the 4T score alone, HDAA alone, and the combination of the 4T score and HDAA results. This preliminary data suggest a diagnostic algorithm combining 4T score, HDAA, and OD value may be a tool to aid in the identification SRA positive patients for DTI therapy.

POST-TRANSFUSION PURPURA VS. HEPARIN-INDUCED THROMBOCYTOPENIA: DIFFERENTIAL DIAGNOSIS IN CLINICAL PRACTICE

2000 ◽  
Vol 10 (4) ◽  
pp. 323-324 ◽  
Author(s):  
F. Araujo ◽  
J. J. Sa ◽  
V. Araujo ◽  
M. Lopes ◽  
L. M. Cunha-Ribeiro
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Heparin Induced Thrombocytopenia

A first approach to compare efficacy and safety of lepirudin and danaparoid in patients with heparin-induced thrombocytopenia (HIT)

2000 ◽  
Vol 10 (4) ◽  
pp. 325-325
Author(s):  
B. Farner ◽  
P. Eichler ◽  
H. Kroll ◽  
G. Urban ◽  
A. Greinacher
Keyword(s):  
Efficacy And Safety ◽  
Heparin Induced Thrombocytopenia

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

The three diagnostic strategies -- Which is the best?

2011 ◽  
Author(s):  
Anna Slysz
Keyword(s):  
Diagnostic Strategies

Mechanism and Clinical Presentation of Heparin-Induced Thrombocytopenia

2001 ◽  
Vol 5 (1) ◽  
pp. 74-80
Author(s):  
Karl-Georg Fischer
Keyword(s):  
Clinical Presentation ◽  
Heparin Induced Thrombocytopenia
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