American Society of Hirudotherapy

Heparin-induced thrombocytopenia: how to manage it, how to avoid it

Review published in Cleve Clin J Med (2000)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentClinical TrialsCaiola E · Cleveland Clinic journal of medicine, 2000

Abstract

Heparin therapy has two potential adverse effects: bleeding and heparin-induced thrombocytopenia (HIT). There are two types of HIT: type I is more common but less severe; type II occurs less frequently but involves severe thrombocytopenia and a high risk for thrombotic events. Treatment involves discontinuing heparin, allowing the platelet count to return to normal, and treating any thrombosis. Lepirudin (Refludan) is the only agent currently approved for the treatment of HIT-related thrombosis, but other agents may have a role in combination therapy. Prevention includes using low molecular weight heparin instead of unfractionated heparin and limiting unfractionated heparin therapy to less than 5 days.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsChondroitin SulfatesDermatan SulfateDrug CombinationsEpoprostenolHeparinHeparin, Low-Molecular-WeightHeparan SulfateHirudin TherapyHirudinsHumansPlatelet Aggregation Inhibitors

Summary

Early review of type I and type II HIT with lepirudin (Refludan) cited as the only agent then approved for HIT-related thrombosis treatment.

Why This Matters for Hirudotherapy

This review discusses heparin-induced thrombocytopenia management and prevention, distinguishing type I (common, mild) from type II (less frequent, severe thrombocytopenia with high thrombotic risk), and outlining treatment as heparin discontinuation, platelet count recovery, and thrombosis treatment. The abstract specifically identifies lepirudin (Refludan) as the only agent currently approved for treatment of HIT-related thrombosis, while noting other agents may have a role in combination therapy, and recommends prevention through low-molecular-weight heparin use and limiting unfractionated heparin duration. This is relevant to ASH's domain because the abstract names lepirudin (Refludan) and its approved status for HIT-related thrombosis, though the abstract itself does not identify lepirudin as hirudin-derived or mention leeches. The caveat is that the abstract offers no dosing or outcome detail specific to lepirudin, and leeches or the broader secretome are not discussed.

Citation

Heparin-induced thrombocytopenia: how to manage it, how to avoid it.

Caiola E · Cleveland Clinic journal of medicine, 2000

DOI

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