Saturday, 2 November 2019

Heparin Induced Thrombocytopenia

Symptoms
Hypercoagulation Symptoms: MI, stroke, limb and organ ischaemia, DVT, PE
Bleeding Complications
Fever, chills, flushing or the skin

Investigations
4Ts: Thrombocytopenia
   Thrombosis
   Timing of Platelets fall
    Thrombocytopenia from other causes

Type I Immune Mediated - platelets normally between 100 and 150. Self limiting. 2 days after heparin administration.
Type II Immune Mediated - Platelet IgG (which cause release of pro-coagulant factors and acute inflammation) complexes removed by splenic macrophages. Thrombocytopaenia >50% in 5-15 days of heparin adminstration.
If someone has had heparin before, this happens quicker.

Fundaparinox induced HIT is rare.


http://calgaryguide.ucalgary.ca/wp-content/uploads/image.php?img=2015/05/Heparin-Induced-Thrombocytopenia.jpg
https://en.wikipedia.org/wiki/Heparin-induced_thrombocytopenia
https://www.bmj.com/content/350/bmj.g7566

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