title: Heparin induced thrombocytopenia: diagnosis and management.
abstract: The incidence of heparin induced thrombocytopenia (HIT) in neurological patients continues to increase with expansion of indication for neurointerventional procedures. The pathophysiology of HIT is related to a hypersensitivity reaction against complex platelet factor 4. The diagnosis is mostly clinical and is often confirmed by laboratory testing. Patients with HIT have a higher rate of thromboembolic complications, both arterial and venous, and with worse neurological outcomes at the time of discharge. Early diagnosis and heparin cessation are essential in the management of those patients. Both immediate and prolonged alternative anticoagulation are necessary. Understanding of the mechanism of action, indication and drug interaction of the alternative anticoagulants (direct thrombin inhibitors, fondaparinux and danaparoid) and warfarin is essential during management of these patients.
authors: Department of Neurosurgery, College of Medicine, University of Illinois at Chicago, 60612-7329, USA. alaraj@uic.edu
authors: Ali
authors: A
authors: Alaraj
authors: Adam
authors: A
authors: Wallace
authors: Eljim
authors: E
authors: Tesoro
authors: Sean
authors: S
authors: Ruland
authors: Sepideh
authors: S
authors: Amin-Hanjani
authors: Fady T
authors: FT
authors: Charbel
authors: Victor
authors: V
authors: Aletich
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D000991:Antithrombins / Q000627:therapeutic use; D006493:Heparin / Q000009:adverse effects*; D006494:Heparin Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D006494:Heparin Antagonists; D006493:Heparin