Heparin induced thrombocytopenia: review

被引:8
作者
Dasararaju, Radhika [1 ]
Singh, Nirupama [1 ]
Mehta, Amitkumar [2 ]
机构
[1] Univ Alabama Birmingham, Dept Transfus Med, Birmingham, AL 35249 USA
[2] Univ Alabama Birmingham, Dept Hematol & Oncol, Birmingham, AL 35294 USA
关键词
argatroban; danaparoid; desirudin; fondaparinux; heparin; heparin-induced thrombocytopenia; HIT; lepirudin; thrombocytopenia; 4T score; MOLECULAR-WEIGHT HEPARIN; RECOMBINANT HIRUDIN; TISSUE FACTOR; ANTIBODIES; THROMBOSIS; RISK; PLATELET-FACTOR-4; DIAGNOSIS; LEPIRUDIN; HIT;
D O I
10.1586/17474086.2013.814446
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heparin induced thrombocytopenia (HIT) is a serious, potentially life and limb threatening immune adverse reaction to heparin. IgG antibodies against platelet factor 4 and heparin multimer complexes activate platelets to create a prothrombotic state. ELISA based immunoassay to detect these antibodies is sensitive while serotonin release assay is highly specific but is not widely available. 4T score is a simple score to calculate pre-test probability of HIT. Score <3 is highly specific to exclude the diagnosis. Alternate anticoagulants like lepirudin, argatroban or danaparoid are recommended in therapeutic dose to treat or prevent thrombotic events in HIT. Increased awareness of this condition among clinicians is important to ensure its early recognition and treatment to avoid serious complications.
引用
收藏
页码:419 / 428
页数:10
相关论文
共 78 条
[41]   IgG-class anti-PF4/heparin antibodies and symptomatic DVT in orthopedic surgery patients receiving different anti-thromboembolic prophylaxis therapeutics [J].
Motokawa, Satoru ;
Torigoshi, Takafumi ;
Maeda, Yumi ;
Maeda, Kazushige ;
Jiuchi, Yuka ;
Yamaguchi, Takayuki ;
Someya, Shinsuke ;
Shindo, Hiroyuki ;
Migita, Kiyoshi .
BMC MUSCULOSKELETAL DISORDERS, 2011, 12
[42]  
Nand S, 1997, AM J HEMATOL, V56, P12, DOI 10.1002/(SICI)1096-8652(199709)56:1<12::AID-AJH3>3.0.CO
[43]  
2-5
[44]   Heparin-induced thrombocytopenia: new evidence for the dynamic binding of purified anti-PF4-heparin antibodies to platelets and the resultant platelet activation [J].
Newman, PM ;
Chong, BH .
BLOOD, 2000, 96 (01) :182-187
[45]   Risk of thrombosis in patients with malignancy and heparin-induced thrombocytopenia [J].
Opatrny, L ;
Warner, MN .
AMERICAN JOURNAL OF HEMATOLOGY, 2004, 76 (03) :240-244
[46]   The pathophysiology of immune-mediated heparin-induced thrombocytopenia [J].
Reilly, RF .
SEMINARS IN DIALYSIS, 2003, 16 (01) :54-60
[47]   Heparin-induced thrombocytopenia - Myths and misconceptions (that will cause trouble for you and your patient) [J].
Rice, L .
ARCHIVES OF INTERNAL MEDICINE, 2004, 164 (18) :1961-1964
[48]   Bilateral adrenal hemorrhage: The unrecognized cause of hemodynamic collapse associated with heparin-induced thrombocytopenia [J].
Rosenberger, Laura H. ;
Smith, Philip W. ;
Sawyer, Robert G. ;
Hanks, John B. ;
Adams, Reid B. ;
Hedrick, Traci L. .
CRITICAL CARE MEDICINE, 2011, 39 (04) :833-838
[49]   Rational design and characterization of platelet factor 4 antagonists for the study of heparin-induced thrombocytopenia [J].
Sachais, Bruce S. ;
Rux, Ann H. ;
Cines, Douglas B. ;
Yarovoi, Serge V. ;
Garner, Lee I. ;
Watson, Stephen P. ;
Hinds, Jillian L. ;
Rux, John J. .
BLOOD, 2012, 119 (25) :5955-5962
[50]   Argatroban therapy for heparin-induced thrombocytopenia in ICU patients with multiple organ dysfunction syndrome: a retrospective study [J].
Saugel, Bernd ;
Phillip, Veit ;
Moessmer, Georg ;
Schmid, Roland M. ;
Huber, Wolfgang .
CRITICAL CARE, 2010, 14 (03)