An update on heparin-induced thrombocytopenia: diagnosis and management

ABSTRACTIntroduction: Heparin-induced thrombocytopenia (HIT) is a drug-mediated, prothrombotic disorder caused by immunization against platelet factor 4 (PF4) after complex formation with heparin or other polyanions. A subset of anti-PF4/heparin antibodies are capable of intravascular platelet activation by cross-linking Fcgamma receptor IIA leading to platelet count decrease and/or thrombosis. HIT can be potentially associated with devastating complications such as life-threatening thrombosis making it one of the most serious adverse drug reactions. Diagnosis of HIT based on clinical information is often difficult.Area covered: This review highlights the pathophysiology of HIT, emphasizing characteristic clinical features and the role of laboratory assays in the diagnosis of HIT. In addition, a summary of current therapeutic options for patients with HIT will be provided.Expert opinion: A combination of clinical pretest scoring system and laboratory investigation is usually necessary to diagnose HIT. If ...