Heparin-induced thrombocytopenia: Update

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy. It is due to the synthesis of antibodies most often directed against platelet factor 4 (FP4) modified by heparin (H). HIT is manifested by a platelet count fall, associated with a high risk of venous or arterial thr...

Full description

Saved in:
Bibliographic Details
Published in:La revue de medecine interne 2022-01, Vol.43 (1), p.18-25
Main Authors: Camoin-Jau, L, Mariotti, A, Suchon, P, Morange, P-E
Format: Article
Language:fre
Subjects:
Anticoagulants - adverse effects
Heparin - adverse effects
Humans
Platelet Count
Thrombocytopenia - chemically induced
Thrombocytopenia - diagnosis
Thrombosis
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy. It is due to the synthesis of antibodies most often directed against platelet factor 4 (FP4) modified by heparin (H). HIT is manifested by a platelet count fall, associated with a high risk of venous or arterial thrombosis. The diagnosis of HIT is based on the assessment of clinical probability (4Ts score or change in platelet count after cardiac surgery) and the demonstration of heparin-modified anti-FP4 antibodies (FP4/H). If the immunological tests are positive, functional tests should be performed. In case of suspicion of HIT, it is necessary to urgently stop heparin therapy, to perform a doppler ultrasound of the lower limbs, and to prescribe an alternative anticoagulation agent at a curative dose. Currently, danaparoid sodium and argatroban are authorized. The diagnosis and management of HIT remain complex and requires multidisciplinary collaboration.
ISSN:1768-3122
DOI:10.1016/j.revmed.2021.08.011