Clinical Case Database / Category: Patient Management
A case of heparin induced thrombocytopenia
Publication details
Dr Richard Soutar, Dr Caroline Betts
Foundation Years Journal, volume 9, issue 3, p.47 (123Doc Education, London, March 2015)
Abstract
This article describes a case of heparin induced thrombocytopenia (HIT) in a patient following above knee amputation for an acute ischaemic lower limb. It discusses the differential diagnoses which should be considered in surgical patients with thrombocytopenia, who is at risk of heparin induced thrombocytopenia, when a diagnosis of HIT should be clinically suspected and briefly how HIT is diagnosed and managed.
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Authors
Dr Richard Soutar
Consultant Haematologist
Gartnavel Hospital, Glasgow, G12 0YN
richard.soutar@nhs.net
Dr Caroline Betts (Corresponding author)
Speciality Registrar in Haematology
Gartnavel Hospital, Glasgow, G12 0YN
caroline.betts@nhs.net
References
1. Stasi R. How to approach thrombocytopenia. ASH Education Book 2012; vol 1: 191-197.
2. Hunt B. Bleeding and coagulopathies in critical care. NEJM 2014;170:847-859.
3. Watson W, Davidson S and Keeling D. Guidelines on the diagnosis and management of heparin induced thrombocytopenia: second edition. BJH 2012;159:528-540.
4. Lo GK, Juhl D, Warkentin TE, Sigouin CS, Eichler P, Greinacher A. Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost. 2006;4(4):759-65.
5. Kelton JG, Arnold DM, Bates SM. Nonheparin anticoagulants for Heparin Induced Thrombocytopenia. NEJM 2013;368:737-744.
6. Cuker A and Cines DB. How I treat heparin-induced thrombocytopenia. Blood 2012;119: 2209-2218.
7. Warkentin, T.E. & Kelton, J.G. (2001) Temporal aspects of heparin-induced thrombocytopenia. NEJM, 344, 1286–1292.
8. Pötzsch B, Klövekorn W-P, Madlener. Use of Heparin during Cardiopulmonary Bypass in Patients with a History of Heparin-Induced Thrombocytopenia. N Engl J Med 2000; 343:515.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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