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Early‐Onset Heparin‐Induced Thrombocytopenia After a 165‐Day Heparin‐Free Interval: Case Report and Review of the Literature
Author(s) -
DeEugenio Deborah L.,
Ruggiero Nicholas J.,
Thomson Lynda J.,
Menajovsky L. Bernardo,
Herman Jay H.
Publication year - 2005
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.25.4.615.61036
Subject(s) - heparin , heparin induced thrombocytopenia , medicine , platelet , thrombosis
Early‐ or abrupt‐onset immune‐mediated heparin‐induced thrombocytopenia (HIT) is defined as HIT that occurs less than 5 days after exposure to heparin in patients who have received heparin within the previous 100 days. We identified no reports in the literature of early‐onset HIT in patients who had a heparin‐free interval longer than 100 days. However, we report a case of early‐onset immune‐mediated HIT illustrated by a positive HIT result with serotonin release and enzyme‐linked immunosorbent assays, and a decrease in platelet count to less than 100 times 10 3 /mm 3 with no evidence of thrombosis, approximately 165 days after the patient's last exposure to heparin. We conclude that clinicians should choose alternative forms of anticoagulation in patients with even a remote history of HIT. If clinicians are compelled to reexpose patients to heparin, they should confirm a negative HIT assay result, monitor for clinical signs of HIT, and provide appropriate treatment if HIT is suspected.