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Heparin-induced thrombocytopenia (HIT) is the development of thrombocytopenia (a low platelet count), due to the administration of various forms of heparin, an anticoagulant. HIT predisposes to thrombosis (the abnormal formation of blood clots inside a blood vessel ).
Laboratory tests might include: full blood count, liver enzymes, renal function and erythrocyte sedimentation rate. [citation needed] If the cause for the high platelet count remains unclear, bone marrow biopsy is often undertaken, to differentiate whether the high platelet count is reactive or essential. [citation needed]
Heparin-induced thrombocytopenia (HIT) is due to an immune system reaction against the anticoagulant drug heparin (or its derivatives). [1] Though it is named for associated low platelet counts, HIT is strongly associated with risk of venous and arterial thrombosis. [19]
Pseudothrombocytopenia (PTCP) or spurious thrombocytopenia is an in-vitro sampling problem which may mislead the diagnosis towards the more critical condition of thrombocytopenia. The phenomenon may occur when the anticoagulant used while testing the blood sample causes clumping of platelets which mimics a low platelet count. [ 1 ]
The diagnosis requires the presence of both A criteria together with B3 to B6, or of criterion A1 together with B1 to B6. [14] The criteria are as follows: [14] A1. Platelet count > 400 × 10 3 /μL for at least 2 months. A2. Acquired V617F JAK2 mutation present; B1. No cause for a reactive thrombocytosis normal inflammatory indices; B2.
One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μL. [5] Thrombocytopenia can be contrasted with the conditions associated with an abnormally high level of platelets in the blood – thrombocythemia (when the cause is unknown), and thrombocytosis (when the cause is known). [6] [7]
Blood tests [2] Differential diagnosis: Thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome [1] Treatment: Directed at the underlying condition [3] Medication: Platelets, cryoprecipitate, fresh frozen plasma, heparin [2] Prognosis: 20–50% risk of death [4] Frequency: 1% of people admitted to hospital [4]
More rarely, this phenomenon had previously been described as an autoimmune phenomenon in people who had not been exposed to heparin. [29] One striking feature of thrombocytopenia in the presence of anti-PF4 antibodies is the propensity of some to develop thrombosis, a phenomenon called heparin-induced thrombocytopenia if heparin is involved. [30]