Treatment of heparin-induced thrombocytopenia

Ann Pharmacother. 2002 Mar;36(3):489-503. doi: 10.1345/aph.1A204.

Abstract

Objective: To describe heparin-induced thrombocytopenia (HIT or HIT-2), an immune-mediated adverse reaction to heparin or low-molecular-weight heparin. Available treatment options and considerations in developing a therapy approach are discussed.

Data sources: A search of the National Library of Medicine (1992-June 2001) was done to identify pertinent literature. Additional references were reviewed from selected articles.

Study selection: Articles related to laboratory recognition and treatment options of HIT, including the use of agents in selected clinical conditions, were reviewed and included.

Conclusions: HIT is a rare but potentially severe adverse reaction to heparin that was, until recently, poorly understood and had limited treatment options. Recent advances describing the recognition and clinical manifestations of immune-mediated HIT, including recently available antithrombotic treatment options, have dramatically changed outcomes for patients having this syndrome.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticoagulants* / adverse effects
  • Anticoagulants* / therapeutic use
  • Arginine / analogs & derivatives
  • Chondroitin Sulfates / therapeutic use
  • Clinical Trials as Topic
  • Coronary Disease / drug therapy
  • Dermatan Sulfate / therapeutic use
  • Drug Combinations
  • Female
  • Heparin / adverse effects*
  • Heparitin Sulfate / therapeutic use
  • Hirudin Therapy
  • Hirudins / analogs & derivatives*
  • Humans
  • Pipecolic Acids / therapeutic use
  • Pregnancy
  • Rabbits
  • Recombinant Proteins / therapeutic use
  • Sulfonamides
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / drug therapy

Substances

  • Anticoagulants
  • Drug Combinations
  • Hirudins
  • Pipecolic Acids
  • Recombinant Proteins
  • Sulfonamides
  • Dermatan Sulfate
  • Heparin
  • Chondroitin Sulfates
  • Heparitin Sulfate
  • Arginine
  • danaparoid
  • argatroban
  • lepirudin