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

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.

This review distinguishes milder type I HIT from type II with severe thrombocytopenia and thrombotic risk, identifies lepirudin (Refludan) as the then-only approved agent for HIT-related thrombosis, and advises low-molecular-weight heparin over unfractionated heparin for prevention.

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