A positive in vitro assay is required to diagnose heparin-induced thrombocytopenia.
A 57-year-old woman is admitted for coronary artery bypass graft. She has had a recent coronary angiogram (with heparin exposure), which revealed high-grade stenoses of the left anterior descending coronary artery, right coronary artery, and left circumflex artery. The preoperative platelet count is 300,000/microL. Heparin is administered during cardiopulmonary bypass. The platelet count on postoperative day 1 is 160,000/microL and on postoperative day 6 is 60,000/microL. Heparin-induced thrombocytopenia (HIT) is suspected and HIT assays are ordered.
Kottke-Marchant
Kandace
K
Section of Hemostasis and Thrombosis, Department of Clinical Pathology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, L30, Cleveland, OH 44195, USA. marchak@ccf.org
Bontempo
Franklin A
FA
D000925:Anticoagulants / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D066298:In Vitro Techniques; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*
D000925:Anticoagulants; D006493:Heparin