Heparin-induced thrombocytopenia: clinical manifestations and management strategies.

Thrombocytopenia is a relatively frequent and usually benign clinical complication of heparin therapy. However, some patients receiving heparin and heparin-based products experience an immune-mediated reaction due to the development of heparin-induced antibodies. This reaction leads to a highly specific and paradoxical form of thrombocytopenia, known as type II heparin-induced thrombocytopenia (HIT).

Early-onset heparin-induced thrombocytopenia after a 165-day heparin-free interval: case report and review of the literature.

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 x 10(3)/mm3 with no evidence of thrombosis, approximately 165 days after the patient's last exposure to heparin.

Benefits of more aggressive VTE prophylaxis in hospitalized medical patients.

Venous thromboembolism (VTE), which includes both deep vein thrombosis and pulmonary embolism, is a well-known risk in surgical patients, but it is also a significant and often unrecognized source of mortality and morbidity in hospitalized medical patients. The need for routine prophylaxis in the general medical population is increasingly supported.