title: Heparin-induced thrombocytopenia: a tremendous opportunity for randomization.
abstract: : Heparin-induced thrombocytopenia and thrombosis (HITT) is both life-threatening with a complex immune-mediated process and clinically challenging to diagnose and treat. What further complicates matters is that thrombocytopenia is a frequently encountered laboratory value but rarely results in clinical signs of HITT. Decades into its initial description, we have anticoagulants with a small therapeutic index and associated high cost. The diagnosis is sometimes equivocal given our current laboratory diagnostics, and can take days to confirm. Furthermore, prior studies that resulted in the approval of anticoagulants for the treatment of heparin-induced thrombocytopenia have been imperfectly designed. Further evaluations of patients with HITT could more adequately define these difficult issues.
authors: aDivision of Hematology Oncology, Knight Cancer Institute bDepartment of Public Health and Preventive Medicine cCenter for Healthcare Ethics, Oregon Health & Science University, Portland, Oregon, USA.
authors: Austin
authors: A
authors: Lammers
authors: Thomas
authors: T
authors: DeLoughery
authors: Vinay
authors: V
authors: Prasad
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants; D006493:Heparin