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[Thrombocytopenia induced by heparin: report of a clinical case]
Heparin-induced thrombocytopenia (HIT) is a possible complication of heparin administration consequent to an immunological reaction. It usually resolves without clinical sequelae with discontinuation of the drug. However, sometimes it causes severe platelet activation with thrombosis. The therapeutic strategy for HIT has only recently been established. In particular, in view of a possible worsening of the thrombotic status, some concerns have been raised about the early use of oral anticoagulation. We report a case of a 57-year-old woman in whom severe HIT occurring after a few days of heparin treatment for pulmonary embolism was treated using low doses of warfarin. The recent literature on HIT is reviewed and the lack, at the present, of valid pharmacological alternatives in Italy is emphasized.
Heparin-induced thrombocytopenia (HIT) is a possible complication of heparin administration consequent to an immunological reaction. It usually resolves without clinical sequelae with discontinuation of the drug. However, sometimes it causes severe platelet activation with thrombosis. The therapeutic strategy for HIT has only recently been established. In particular, in view of a possible worsening of the thrombotic status, some concerns have been raised about the early use of oral anticoagulation. We report a case of a 57-year-old woman in whom severe HIT occurring after a few days of heparin treatment for pulmonary embolism was treated using low doses of warfarin. The recent literature on HIT is reviewed and the lack, at the present, of valid pharmacological alternatives in Italy is emphasized.