Американское общество гирудотерапии

Overview of heparin-induced thrombocytopenia.

Review published in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists (2003)

Последнее обновление: June 18, 2026Рецензент: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewКлинические исследованияРазработка лекарственных препаратовSpinler et al. · American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2003

Abstract

A brief overview of the pathophysiology, diagnosis, and treatment of heparin-induced thrombocytopenia (HIT) is discussed. Following any exposure to unfractionated heparin or low-molecular-weight heparin (LMWH), HIT, a serious allergic drug reaction, may occur. The frequency of HIT is thought to range from 1 to 5% of patients receiving heparin. This immune-mediated syndrome is paradoxically associated with thrombosis, not bleeding, with thrombin generation playing a central role. The diagnosis of HIT is based upon clinical findings that can be confirmed with laboratory assay; however, when there is clinical suspicion of HIT, all forms of heparin therapy should be immediately discontinued and initiation of alternative anticoagulation is strongly encouraged. In the presence of HIT, the use of LMWHs or initiation of warfarin without additional effective anticoagulation is not recommended. Argatroban and lepirudin, two direct thrombin inhibitors (DTIs), are approved by the Food and Drug Administration for the management of HIT. Both agents have been studied in the treatment and prevention of thrombotic events associated with HIT. Argatroban, a univalent inhibitor of thrombin, is eliminated via the liver, while lepirudin, the first DTI approved for HIT, is a bivalent thrombin inhibitor that is cleared by the kidneys. Neither argatroban nor lepirudin demonstrates cross-reactivity with heparin-induced antibodies, and both DTIs have been associated with effective anticoagulation and platelet recovery in patients with HIT. The appropriate use of DTIs in HIT reduces the risk of thrombotic events and severe consequences associated with this serious drug reaction.

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

Publication typeJournal ArticleReview
Indexed MeSH termsAntithrombinsEconomics, PharmaceuticalHeparinHumansThrombocytopeniaUnited States

Резюме

A brief overview of the pathophysiology, diagnosis, and treatment of heparin-induced thrombocytopenia (HIT) is discussed. Following any exposure to unfractionated heparin or low-molecular-weight heparin (LMWH), HIT, a serious allergic drug reaction, may occur.

Почему это важно для гирудотерапии

This review provides an overview of the pathophysiology, diagnosis, and treatment of heparin-induced thrombocytopenia (HIT), an immune-mediated syndrome occurring in 1–5% of heparin-exposed patients and paradoxically associated with thrombosis rather than bleeding. The abstract notes that argatroban and lepirudin—two direct thrombin inhibitors—are FDA-approved for HIT management, describing lepirudin as a bivalent thrombin inhibitor cleared by the kidneys that does not cross-react with heparin antibodies and has been associated with effective anticoagulation and platelet recovery. The clinical discussion of lepirudin for HIT is relevant to ASH's domain. CAVEAT: The publication type is listed as 'Review'; the abstract does not describe lepirudin's relationship to natural hirudin or leeches, so the leech therapy connection is not established by this source.

Цитирование

Overview of heparin-induced thrombocytopenia.

Spinler et al. · American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2003

Связанный клинический контекст

Узнайте, как это исследование связано с клинической практикой

Добавлено в библиотеку ASH: May 28, 2026 · Последнее обновление сайта: June 18, 2026

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