We present three clinical cases that illustrate some of the key features of the diagnosis
and management of immune-mediated heparin-induced thrombocytopenia (HIT). The importance
of having a high clinical suspicion for HIT in the appropriate clinical setting is
emphasized. Early therapeutic decisions should be based on a clinical diagnosis, with
laboratory tests serving as confirmation. Low-molecular-weight and unfractionated
heparins are to be strictly avoided in patients with HIT. Identification bracelets
or necklaces may be useful to reduce inappropriate administration of these agents
to patients with HIT presenting with acute coronary syndromes.
KEYWORDS
Heparin-induced thrombocytopenia - HIT - clinical diagnosis - laboratory tests - treatment
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David C SaneM.D.
Associate Professor of Internal Medicine, Section of Cardiology, Wake Forest University
School of Medicine
Medical Center Boulevard, Winston-Salem
NC 27157-1045
eMail: dsane@wfubmc.edu
