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| Year : 2011 | Volume
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| Issue : 2 | Page : 179-180 |
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| Re: Heparin-induced thrombocytopenia - Type 2 |
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Vipul D Yagnik
Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India
Click here for correspondence address and email
| Date of Web Publication | 28-Jul-2011 |
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How to cite this article:
Yagnik VD. Re: Heparin-induced thrombocytopenia - Type 2. Asian J Transfus Sci 2011;5:179-80 |
Sir,
I read an article entitled "Heparin-induced thrombocytopenia (HIT) - Type 2" [1] with interest. I would like to congratulate author for his effort to concise such a topic in a nice manner. However, I would like to add few more information regarding this entity which you may find useful [Table 1].
Pretest probability is calculated on the basis of 4Ts: Thrombocytopenia, timing of thrombocytopenia, thrombosis, other cause of thrombocytopenia. Probability is high if more than 50% drop in platelet count after 5 days of initiation of heparin and new development of thrombosis with no other cause for thrombocytopenia.
I would like to summarize the treatment for HIT: Stop heparin, postpone warfarin until substantial recovery in platelet count, avoid platelet transfusions, [3] start alternative anticoagulants like lepirudin and argatroban (direct thrombin inhibitor), danaparoid, or fondaparinux (factor Xa inhibitor).
Fondaparinux is a synthetic heparin pentasaccharide which does not cross-react with HIT antibodies and can be used for the treatment of HIT. [4]
 References | |  |
| 1. | Majeed TA. Heparin induced thrombocytopenia-type 2. Asian J Transfus Sci 2010;4:137. 
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| 2. | Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med 1995;332:1330-5.
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| 3. | Warkentin TE. Heparin-induced thrombocytopenia: Diagnosis and management. Circulation 2004;110:e454-8.
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| 4. | Kuo KH, Kovacs MJ. Successful treatment of heparin induced thrombocytopenia (HIT) with fondaparinux. Thromb Haemost 2005;93 : 999-100.
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Correspondence Address:
Vipul D Yagnik
77, Siddhraj Nagar, Rajmahal Road, Patan - 384 265, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-6247.83254
[Table 1] |
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