Publication details

Heparinem indukovaná trombocytopenie: kazuistika a přehled literatury

Title in English Heparin induced thrombocytopenia: a case report and literature overview
Authors

POLÁK Pavel KALOUDOVÁ Yvona KRUPICOVÁ Hana COUFAL Pavel LIPOVÝ Břetislav ZAVŘELOVÁ Jiřina PRUDKOVÁ Marie ŠTĚPAŘOVÁ Andrea ŘÍHOVÁ Lucie BEZDĚKOVÁ Renata KRÁLOVÁ Romana FROLA Lukáš PENKA Miroslav

Year of publication 2020
Type Article in Periodical
Magazine / Source Vnitřní lékařství
Citation
Web https://casopisvnitrnilekarstvi.cz/artkey/vnl-202004-0005_heparin-induced-thrombocytopenia-a-case-report-and-literature-overview.php
Keywords fondaparinux; heparin induced thrombocytopenia; direct oral anticoagulants; thrombosis; 4T score
Description Heparin induced thrombocytopenia (HIT) is an immunologically-mediated complication, which usually follows heparin exposition, less frequently exposition to other drugs or even occurs spontaneously. The type of heparin, its dose and mode of application as well as the exposition time, major trauma or operation, and obesity represent the main risk factors for HIT. The probability of HIT correlates with so-called 4T score. A confirmatory laboratory diagnostic should be exclusively reserved for patients with a medium to a high probability of HIT development (more than 3 points in 4T score). The screening method is based on serological detection of antibodies against heparin-platelet factor-4 complexes; confirmation tests aim to identify the activation of platelets. The treatment of HIT requires an immediate interruption of heparin application and rigorous antithrombotic treatment with an alternative agent. Herein authors describe a clinical case of HIT manifested as an extreme urticarial reaction in the location of nadroparin application as well as thrombosis of deep subcutaneous veins in a polymorbid obese patient with an extensive and infected burn. Due to timely diagnosis and fondaparinux treatment, no more severe thrombotic events occurred in this patient.

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