Heparin-induced thrombocytopenia (HIT) is a rare but very important condition characterized by a sudden decrease in the platelet count of more than 50% from the highest platelet count following heparin treatment. The sitution usually includes hypercoagulability, and the presence of heparin-dependent, platelet-activating IgG antibodies. Anti-protamine/heparin and anti-PF4/heparin antibody tests may be helpful and should be ordered only if clinical features reasonably suggest HIT.
The urgent cessation of heparin and the initiation of therapeutic-dose anticoagulation with an alternative agent (argatroban, danaparoid, fondaparinux, or bivalirudin) have been suggested for the treatment of HIT. Treatment with intravenous immunoglobulin G has been reported as a succesful approach. Another important point is that warfarin also should be avoided in patients with acute HIT.
This serious and life threatining autoimmune condition, must be considered for early diagnosis and prompt treatment in the patients who treated with heparin in neurointensive care units.
Heparin-induced thrombocytopenia, neurointensive care, thrombosis, heparin
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