Lower extremity manifestations and treatment of heparin-induced thrombocytopenia syndromes: a cohort study.
Heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia with thrombosis (HITT) syndromes are the result of an adverse reaction to heparin that results in a spectrum of laboratory and end-organ manifestations secondary to thrombosis of both arterial and venous small and large vessels. HITT most often manifests in the extremities as acral ischemia and necrosis, with a spectrum of severity. The lower extremity surgical patient is at risk for deep venous thrombosis, and when exposed to heparin products, is also at risk for the development of a heparin-induced thrombocytopenic syndrome. This article reports on a cohort of patients from a tertiary referral lower extremity reconstruction practice with the HIT/HITT syndromes, with an analysis of the frequency, medical characteristics, clinical settings, lower extremity manifestations, management, and outcomes of patients with HIT/HITT.).
Foot & Ankle Section, Department of Orthopaedics, Marshfield Clinic, Marshfield, WI, USA.
Christopher
C
Bibbo
Philip Shawn
PS
Hatfield
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D010979:Platelet Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*
D000925:Anticoagulants; D006493:Heparin