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Heparin induced thrombocytopenia


Authors: J. Novotný;  M. Penka
Authors‘ workplace: Oddělení klinické hematologie, FN Brno
Published in: Transfuze Hematol. dnes,27, 2021, No. 1, p. 9-15.
Category: Review/Educational Papers
doi: https://doi.org/10.48095/cctahd20219

Overview

Heparin induced thrombocytopenia (HIT) represents a very serious complication of heparin therapy associated with high morbidity and/or mortality. HIT is caused by generation of antibodies against macromolecular complexes of heparin/platelet factor 4 resulting in activation of platelets, monocytes, endothelium and neutrophils with subsequent high thrombin generation and induction of a hypercoagulable state. Therapy with heparins must be interrupted and alternative non-heparin antithrombotics must be introduced. The dia­gnosis of HIT is based on clinical findings namely the so called 4T score and laboratory tests. Immunological tests have a high negative predictive value in excluding HIT. In positive cases, the dia­gnosis must be confirmed by functional tests. Novel developments in the therapy of HIT include the introduction of the new direct oral anticoagulants.

Keywords:

heparin induced thrombocytopenia – thrombosis – non-heparin anticoagulants – direct oral anticoagulants – DOACs


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Haematology Internal medicine Clinical oncology

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