HEPARIN-INDUCED THROMBOCYTOPENIA (HIT)
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Wikipedia defines Heparin Induced Thrombocytopenia (HIT) as:
“Heparin Induced Thrombocytopenia (HIT) with or without thrombosis (HITT) is thrombocytopenia (low platelet counts) due to the administration of heparin. While it is mainly associated with unfractionated heparin (UFH), it can also occur with exposure to low-molecular weight heparin (LMWH), but at significantly lower rates. Despite the low platelet count, it is a thrombotic disorder, with very high rates of thrombosis, in the arteries with or without venous complications. Of note, the rate of DVT (deep vein thrombosis) is roughly 4 times that of arterial thrombosis, and while thrombocytopenia is the most common "event" in HIT, DVT is in fact the most common complication. HIT typically develops 4-14 days after the administration of heparin. Heparin (UFH) is used in cardiovascular surgery, as prevention or treatment for deep-vein thrombosis and pulmonary embolism and in various other clinical scenarios. LMWH is increasingly used in outpatient prophylaxis regimes. There are two forms of HIT. Type II HIT is the main adverse effect of heparin use.”
HIT usually occurs around 5 days after a patient has been given heparin but can occur sooner if the patient has had previous exposure to heparin. The following are complications that can occur due to HIT:
· Deep vein thrombosis
· Pulmonary embolism
· Myocardial infarction
· Occlusion of limb arteries (possibly resulting in amputation)
· Cerebrovascular accidents (stroke, TIA)
· Skin necrosis
· End-organ damage
· Death
Clinical data have shown approximately 20% of patients loses a limb and about 30% of patients die without appropriate alternative non heparin therapy. Unfortunately, HIT generally goes undiagnosed causing serious injuries to patients. I am currently handling HIT cases in San Antonio and have seen first hand the catastrophic injuries involved. The medical community needs to become better educated on diagnosing and treating HIT.
For more information on HIT, please visit the following web site: http://www.argatroban.com/hit_faqs.htm