Prevalence and Clinical Predictors of Heparin Induced Thrombocytopenia

ABSTRACT

Back Ground Heparin induced thrombocytopenia (HIT) isthrombocytopenia or thrombosis with one or more positivetests for HIT antibodies. To diagnose HIT, platelet countmonitoring; at least every other day until hospital discharge forday 14 (whichever occurs sooner). A platelet count fall of 50%or greater from baseline or any thrombosis occurs 5 to 10 daysafter heparin starting with exclusion or other causes ofthrombocytopenia are highly suggestive of HIT. Laboratoryconfirming assays are helpful as platelet activations assay.Management of HIT includes discontinuing of any type ofheparin and using an alternative anticoagulant as DTIs(liperudin, argatropan, bivalerudin). Warfarin should be delayedpending substantial recovery of the platelet account.Methods: This study was conducted to 100 patients receivingheparin in a variety of clinical settings to assess the prevalenceof HIT trying to identify clinical predictors of such complication.To all these patients platelet count every other day from baseline to day 14 was done then the 4T score system was appliedto all patients.Results: Only 6 patients developed HIT; 4 of them developedthrombosis and 3 patients died in hospital due to thesethromboembolic events. UFH, surgical treatment and firstheparin exposure were the clinical predictors of HIT.Conclusion: HIT is a serious and life threatening complicationof heparin therapy that should be early diagnosed and properlymanaged to prevent its thromboembolic complications.