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Hats Off to HIT: A Case Report.

Akhwand Shakeel Ahmad, Dhia Jaber Al-Layla, Manjula Dhinakar

Oman Medical Journal

|July 20, 2012

Summary

Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy. Early diagnosis is crucial, even when heparin is discontinued, to prevent further harm.

Area of Science:

Hematology
Clinical Medicine
Pharmacology

Background:

Thrombocytopenia is a known complication associated with heparin treatment.
Diagnosis of heparin-induced thrombocytopenia (HIT) is primarily clinical, with laboratory tests mainly used to rule out the condition.

Observation:

A patient with stroke developed sepsis from aspiration pneumonia, followed by atrial fibrillation.
Heparin was administered for atrial fibrillation but discontinued due to melena (gastrointestinal bleeding).
Within five days of heparin initiation, the patient developed thrombocytopenia, indicative of HIT.

Findings:

The diagnosis of heparin-induced thrombocytopenia (HIT) was initially missed.
The missed diagnosis occurred because heparin was no longer listed on the patient's active drug chart.

Keywords:

Atrial fibrillation Heparin-induced thrombocytopenia Stroke

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Implications:

This case highlights the importance of considering HIT even after heparin discontinuation.
Clinical vigilance and thorough patient history are essential for accurate HIT diagnosis.
Prompt recognition and management of HIT are critical to prevent thrombotic complications.