Heparin-Induced Thrombocytopenia Differential Diagnoses
- Author: Sancar Eke, MD; Chief Editor: Emmanuel C Besa, MD more...
Differential Diagnoses
- Disseminated Intravascular Coagulation
- Drug-Induced Thrombocytopenia
- Hemolytic-Uremic Syndrome
- Immune Thrombocytopenic Purpura
- Posttransfusion Thrombocytopenia
- Systemic Lupus Erythematosus
- Thrombotic Thrombocytopenic Purpura
[Guideline] Warkentin TE, Greinacher A. Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. Sep 2004;126(3 suppl):311S-337S. [Medline]. [Full Text].
Warkentin TE, Roberts RS, Hirsh J, Kelton JG. An improved definition of immune heparin-induced thrombocytopenia in postoperative orthopedic patients. Arch Intern Med. Nov 10 2003;163(20):2518-24. [Medline]. [Full Text].
Visentin GP, Ford SE, Scott JP, Aster RH. Antibodies from patients with heparin-induced thrombocytopenia/thrombosis are specific for platelet factor 4 complexed with heparin or bound to endothelial cells. J Clin Invest. Jan 1994;93(1):81-8. [Medline]. [Full Text].
Chong BH, Fawaz I, Chesterman CN, Berndt MC. Heparin-induced thrombocytopenia: mechanism of interaction of the heparin-dependent antibody with platelets. Br J Haematol. Oct 1989;73(2):235-40. [Medline].
Kelton JG, Sheridan D, Santos A, et al. Heparin-induced thrombocytopenia: laboratory studies. Blood. Sep 1988;72(3):925-30. [Medline]. [Full Text].
Anderson GP. Insights into heparin-induced thrombocytopenia. Br J Haematol. Apr 1992;80(4):504-8. [Medline].
Newman PM, Chong BH. Heparin-induced thrombocytopenia: new evidence for the dynamic binding of purified anti-PF4-heparin antibodies to platelets and the resultant platelet activation. Blood. Jul 1 2000;96(1):182-7. [Medline].
Rauova L, Poncz M, McKenzie SE, et al. Ultralarge complexes of PF4 and heparin are central to the pathogenesis of heparin-induced thrombocytopenia. Blood. Jan 1 2005;105(1):131-8. [Medline]. [Full Text].
Schmitt BP, Adelman B. Heparin-associated thrombocytopenia: a critical review and pooled analysis. Am J Med Sci. Apr 1993;305(4):208-15. [Medline].
Arepally G, Cines DB. Heparin-induced thrombocytopenia and thrombosis. Clin Rev Allergy Immunol. Fall 1998;16(3):237-47. [Medline].
Warkentin TE. Heparin-induced thrombocytopenia: a ten-year retrospective. Annu Rev Med. 1999;50:129-47. [Medline].
Warkentin TE, Eikelboom JW. Who is (still) getting HIT?. Chest. Jun 2007;131(6):1620-2. [Medline].
Smythe MA, Koerber JM, Mattson JC. The incidence of recognized heparin-induced thrombocytopenia in a large, tertiary care teaching hospital. Chest. Jun 2007;131(6):1644-9. [Medline]. [Full Text].
Warkentin TE, Kelton JG. A 14-year study of heparin-induced thrombocytopenia. Am J Med. Nov 1996;101(5):502-7. [Medline].
Warkentin TE, Levine MN, Hirsh J, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. May 18 1995;332(20):1330-5. [Medline]. [Full Text].
Nand S, Wong W, Yuen B, et al. Heparin-induced thrombocytopenia with thrombosis: incidence, analysis of risk factors, and clinical outcomes in 108 consecutive patients treated at a single institution. Am J Hematol. Sep 1997;56(1):12-6. [Medline]. [Full Text].
Boshkov LK, Warkentin TE, Hayward CP, Andrew M, Kelton JG. Heparin-induced thrombocytopenia and thrombosis: clinical and laboratory studies. Br J Haematol. Jun 1993;84(2):322-8. [Medline].
King DJ, Kelton JG. Heparin-associated thrombocytopenia. Ann Intern Med. Apr 1984;100(4):535-40. [Medline].
Lewis BE, Wallis DE, Hursting MJ, Levine RL, Leya F. Effects of argatroban therapy, demographic variables, and platelet count on thrombotic risks in heparin-induced thrombocytopenia. Chest. Jun 2006;129(6):1407-16. [Medline]. [Full Text].
Warkentin TE, Sheppard JA, Sigouin CS, Kohlmann T, Eichler P, Greinacher A. Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia. Blood. Nov 1 2006;108(9):2937-41. [Medline]. [Full Text].
Greinacher A, Farner B, Kroll H, Kohlmann T, Warkentin TE, Eichler P. Clinical features of heparin-induced thrombocytopenia including risk factors for thrombosis. A retrospective analysis of 408 patients. Thromb Haemost. Jul 2005;94(1):132-5. [Medline].
Warkentin TE. Clinical presentation of heparin-induced thrombocytopenia. Semin Hematol. Oct 1998;35(4 suppl 5):9-16; discussion 35-6. [Medline].
Levine RL, McCollum D, Hursting MJ. How frequently is venous thromboembolism in heparin-treated patients associated with heparin-induced thrombocytopenia?. Chest. Sep 2006;130(3):681-7. [Medline]. [Full Text].
Warkentin TE, Kelton JG. Delayed-onset heparin-induced thrombocytopenia and thrombosis. Ann Intern Med. Oct 2 2001;135(7):502-6. [Medline].
Greinacher A, Warkentin TE. Recognition, treatment, and prevention of heparin-induced thrombocytopenia: review and update. Thromb Res. 2006;118(2):165-76. [Medline].
Warkentin TE. An overview of the heparin-induced thrombocytopenia syndrome. Semin Thromb Hemost. Jun 2004;30(3):273-83. [Medline].
Kadidal VV, Mayo DJ, Horne MK. Heparin-induced thrombocytopenia (HIT) due to heparin flushes: a report of three cases. J Intern Med. Sep 1999;246(3):325-9. [Medline]. [Full Text].
Heeger PS, Backstrom JT. Heparin flushes and thrombocytopenia. Ann Intern Med. Jul 1986;105(1):143. [Medline].
Doty JR, Alving BM, McDonnell DE, Ondra SL. Heparin-associated thrombocytopenia in the neurosurgical patient. Neurosurgery. Jul 1986;19(1):69-72. [Medline].
Rizzoni WE, Miller K, Rick M, Lotze MT. Heparin-induced thrombocytopenia and thromboembolism in the postoperative period. Surgery. Apr 1988;103(4):470-6. [Medline].
Ling E, Warkentin TE. Intraoperative heparin flushes and subsequent acute heparin-induced thrombocytopenia. Anesthesiology. Dec 1998;89(6):1567-9. [Medline].
Warkentin TE, Cook RJ, Marder VJ, Sheppard JA, Moore JC, Eriksson BI, et al. Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin. Blood. Dec 1 2005;106(12):3791-6. [Medline]. [Full Text].
Sheridan D, Carter C, Kelton JG. A diagnostic test for heparin-induced thrombocytopenia. Blood. Jan 1986;67(1):27-30. [Medline]. [Full Text].
Eichler P, Raschke R, Lubenow N, et al. The new ID-heparin/PF4 antibody test for rapid detection of heparin-induced antibodies in comparison with functional and antigenic assays. Br J Haematol. Mar 2002;116(4):887-91. [Medline].
Arepally G, Reynolds C, Tomaski A, et al. Comparison of PF4/heparin ELISA assay with the 14C-serotonin release assay in the diagnosis of heparin-induced thrombocytopenia. Am J Clin Pathol. Dec 1995;104(6):648-54. [Medline].
Chong BH, Burgess J, Ismail F. The clinical usefulness of the platelet aggregation test for the diagnosis of heparin-induced thrombocytopenia. Thromb Haemost. Apr 1 1993;69(4):344-50. [Medline].
Look KA, Sahud M, Flaherty S, Zehnder JL. Heparin-induced platelet aggregation vs platelet factor 4 enzyme-linked immunosorbent assay in the diagnosis of heparin-induced thrombocytopenia-thrombosis. Am J Clin Pathol. Jul 1997;108(1):78-82. [Medline].
Whitlatch NL, Kong DF, Metjian AD, Arepally GM, Ortel TL. Validation of the high-dose heparin confirmatory step for the diagnosis of heparin-induced thrombocytopenia. Blood. Sep 9 2010;116(10):1761-6. [Medline].
Meyer O, Salama A, Pittet N, Schwind P. Rapid detection of heparin-induced platelet antibodies with particle gel immunoassay (ID-HPF4). Lancet. Oct 30 1999;354(9189):1525-6. [Medline].
Berry C, Tcherniantchouk O, Ley EJ, et al. Overdiagnosis of heparin-induced thrombocytopenia in surgical ICU patients. J Am Coll Surg. Jul 2011;213(1):10-7; discussion 17-8. [Medline].
Baroletti S, Hurwitz S, Conti NA, et al. Thrombosis in suspected heparin-induced thrombocytopenia occurs more often with high antibody levels. Am J Med. Jan 2012;125(1):44-9. [Medline].
Hein PA, Lembcke A, Rogalla P. Images in cardiovascular medicine. Multiple thrombosis with aortic occlusion after heparin-induced thrombocytopenia demonstrated by multislice computed tomography. Circulation. Feb 14 2006;113(6):e80-3. [Medline]. [Full Text].
Reilly MP, Taylor SM, Franklin C, et al. Prothrombotic factors enhance heparin-induced thrombocytopenia and thrombosis in vivo in a mouse model. J Thromb Haemost. Dec 2006;4(12):2687-94. [Medline]. [Full Text].
Reilly MP, Taylor SM, Hartman NK, et al. Heparin-induced thrombocytopenia/thrombosis in a transgenic mouse model requires human platelet factor 4 and platelet activation through FcgammaRIIA. Blood. Oct 15 2001;98(8):2442-7. [Medline]. [Full Text].
Warkentin TE. Heparin-induced thrombocytopenia: diagnosis and management. Circulation. Nov 2 2004;110(18):e454-8. [Medline]. [Full Text].
Vanholder RC, Camez AA, Veys NM, et al. Recombinant hirudin: a specific thrombin inhibiting anticoagulant for hemodialysis. Kidney Int. Jun 1994;45(6):1754-9. [Medline].
van Wyk V, Badenhorst PN, Luus HG, Kotze HF. A comparison between the use of recombinant hirudin and heparin during hemodialysis. Kidney Int. Oct 1995;48(4):1338-43. [Medline].
Fischer KG, van de Loo A, Bohler J. Recombinant hirudin (lepirudin) as anticoagulant in intensive care patients treated with continuous hemodialysis. Kidney Int Suppl. Nov 1999;S46-50. [Medline].
Kern H, Ziemer S, Kox WJ. Bleeding after intermittent or continuous r-hirudin during CVVH. Intensive Care Med. Nov 1999;25(11):1311-4. [Medline].
Gajra A, Vajpayee N, Smith A, Poiesz BJ, Narsipur S. Lepirudin for anticoagulation in patients with heparin-induced thrombocytopenia treated with continuous renal replacement therapy. Am J Hematol. May 2007;82(5):391-3. [Medline]. [Full Text].
Smythe MA, Warkentin TE, Stephens JL, Zakalik D, Mattson JC. Venous limb gangrene during overlapping therapy with warfarin and a direct thrombin inhibitor for immune heparin-induced thrombocytopenia. Am J Hematol. Sep 2002;71(1):50-2. [Medline]. [Full Text].
Swan SK, Hursting MJ. The pharmacokinetics and pharmacodynamics of argatroban: effects of age, gender, and hepatic or renal dysfunction. Pharmacotherapy. Mar 2000;20(3):318-29. [Medline].
Greinacher A, Lubenow N. Heparin-induced thrombocytopenia. In: Arnout J, de Gaetano G, Hoylaerts M, et al, eds. Thrombosis: Fundamental and Clinical Aspects. Leuven, Belgium: Leuven University Press; 2003..

