Heparin induced thrombocytopenia with thrombosis, or the "white clot syndrome" is a rare but very important complication of heparin therapy. The syndrome is idiosyncrasic, immune-mediated and not dose dependent and therefore is equally likely to occur with prophylactic and therapeutic heparin dosage regimens. We report a typical case of HIT that occurs with prophylactic heparin therapy and results in bilateral amputation of the lower limbs. We discuss this important condition and some guidelines on its prevention and treatment.
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