Heparin-induced thrombocytopenia in children

Objective: To audit the frequency of heparinoid (standard heparin and low molecular weight heparin) use in a tertiary paediatric hospital, and to determine the occurrence of heparin-induced thrombocytopenia (HIT). Methods: A 1-week cross-sectional audit of all heparinoids given to inpatients at a tertiary paediatric hospital was undertaken and a retrospective medical record review of all suspected HIT cases at the tertiary paediatric centre over a 2-year period was carried out. Results: One hundred and sixteen patients received heparinoid medications over a 7-day period. An average of 29 children received heparin daily. The retrospective medical record review identified four patients with suspected HIT over a 2-year period. Two patients developed thrombotic complications, which were fatal in one patient. Conclusion: Heparin is used frequently in paediatric tertiary hospitals, yet the occurrence of HIT in children is much lower than that reported in adults. Improved laboratory techniques could facilitate improved screening and diagnosis of this serious adverse drug reaction.