Antikoagulation bei HIT II: Wann therapeutisch -
wann prophylaktisch?

Einleitung

Die Pathogenese der Heparin-induzierten Thrombozytopenie vom Typ II (HIT II), einer potenziell schweren Komplikation bei prophylaktischer oder therapeutischer Heparinisierung, ist mittlerweile recht gut geklärt. Auch der Bekanntheitsgrad dieses immunologisch vermittelten Krankheitsbildes ist im Laufe der vergangenen zehn Jahre deutlich gewachsen. So stand zu Beginn der neunziger Jahre noch die Aufklärung über dieses Krankheitsbild und die rechtzeitige Diagnose und Therapie im Vordergrund. Dagegen muss heute verstärkt darauf hingewiesen werden, dass nicht jede sich unter Heparinisierung entwickelnde Thrombozytopenie als HIT II einzustufen ist. Insbesondere bei intensivpflichtigen Patienten sind mögliche andere Ursachen einer Thrombozytopenie differenzialdiagnostisch genau abzuklären.

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