title: Heparin induced thrombocytopenia: diagnosis and contemporary antithrombin management.
abstract: Heparin-induced thrombocytopenia (HIT) may be complicated by severe thrombotic complications and death. Currently no specific laboratory test is available to make the diagnosis. When HIT is clinically suspected, heparin should be discontinued immediately. While no specific therapy for HIT exists, there is increasing evidence that acute antithrombin therapy may significantly reduce morbidity and mortality. Among several agents, the direct antithrombins, such as r-hirudin and argatroban, look the most promising for acute treatment.
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School Boston, Massachusetts 02114, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Januzzi
authors.forename: I K
authors.initials: IK
authors.lastname: Jang
mesh_terms: D000721:Ancrod / Q000494:pharmacology / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D002809:Chondroitin Sulfates / Q000493:pharmacokinetics / Q000627:therapeutic use; D003871:Dermatan Sulfate / Q000493:pharmacokinetics / Q000627:therapeutic use; D004338:Drug Combinations; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005544:Forecasting; D005734:Gangrene / Q000139:chemically induced; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006493:Heparin / Q000009:adverse effects*; D006497:Heparan Sulfate / Q000493:pharmacokinetics / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D006801:Humans; D010875:Pipecolic Acids / Q000493:pharmacokinetics / Q000627:therapeutic use; D010974:Platelet Aggregation / Q000187:drug effects; D011486:Protein C / Q000502:physiology; D011994:Recombinant Proteins / Q000493:pharmacokinetics / Q000627:therapeutic use; D013449:Sulfonamides; D013917:Thrombin / Q000037:antagonists & inhibitors*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000721:Ancrod; D001120:Arginine; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D005343:Fibrinolytic Agents; D006493:Heparin; D006497:Heparan Sulfate; D006629:Hirudins; D010875:Pipecolic Acids; D011486:Protein C; D011994:Recombinant Proteins; D013449:Sulfonamides; D013917:Thrombin; D014859:Warfarin; C035838:danaparoid; C031942:argatroban; C083544:lepirudin