Diagnosis and management of heparin-induced thrombocytopenia.
Diagnosis and management of heparin-induced thrombocytopenia.
复制标题
肝素诱导的血小板减少症的诊断和治疗。
DOI：
10.1016/j.hoc.2013.02.001
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Arepally,GowthamiM
中科院分区：
文献类型：
--
作者：
Lee,GraceM;Arepally,GowthamiM
Unfractionated heparin (UFH) and its derivatives, the low-molecular weight heparins (LMWHs; henceforth, collectively referred to as heparin), remain the most commonly prescribed anticoagulants for the prophylaxis and treatment of venous thromboembolism (VTE) in hospitalized patients. 1 In a subset of treated patients (< 5%), heparin elicits a lifethreatening immune complication, heparin-induced thrombocytopenia (HIT). HIT is a selflimited hypercoagulable disorder occurring predominantly in hospitalized patients. The cardinal manifestations of HIT are declining platelet counts within 5-14 days after heparin exposure and a predilection for arterial and venous thrombosis. 2The clinical syndrome of HIT was first described in the 1950’s by Weissman & Tobin. 3 Subsequent studies revealed the immune origins of this syndrome4 with the identification of antibodies directed to antigenic complexes of platelet factor 4 (PF4) and heparin (H). 5 With the advent of immunoassays for detection of PF4/H antibodies, it is now recognized that an asymptomatic immune response to PF4/H occurs far more commonly than clinical complications of disease (thrombocytopenia and/or thrombosis). This chapter reviews our current understanding of the pathogenesis, clinical features, laboratory testing and therapeutic options for patients with HIT.
