Heparin-induced Thrombocytopenia
(HIT; Heparin-induced Low Blood Platelet Count)
Pronounced: Hep-AH-ren IN-do-ced Thrombo-s-EYE-toe-PEE-nee-a
Definition
Thrombocytopenia means low blood platelet count. These are a special type of blood cell. They help form clots so that you do not bleed too much.
Heparin is a blood thinner that lowers the risk of blood clots. Heparin-induced thrombocytopenia (HIT) is low blood platelet count caused by heparin. It can lead to too much blood clotting. Too much bleeding is rare.
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Causes
HIT is caused by platelets clumping due to an immune reaction to heparin. The clumping uses them up and lowers the count.
Risk Factors
Taking heparin is a risk for having this health problem.
Symptoms
Symptoms are from blood vessels being blocked:
- Pain or swelling in the legs
- Chest pain
- Problems breathing
- Anxiety
- Sweating
- Rapid, uneven heartbeat
- Headache
Diagnosis
You will be asked about your symptoms and health history. An exam will be done.
Blood tests will be done to check your platelet count.
Treatment
Treatment may include:
- Stopping the use of heparin.
- Blood thinners to lower the risk of blood clots.
- Vitamin K antagonists (VKA) therapy—in people taking a VKA, it will be stopped and vitamin K will be given; the VKA will be started again when the person's platelet count is normal.
- Platelet transfusion may be given to replace used up platelets if there is a lot of bleeding, but this is rare.
Prevention
To lower the chance of this problem:
- Avoid heparin use.
- Take other blood thinners.
RESOURCES:
American Heart Association
http://www.heart.org
Family Doctor—American Academy of Family Physicians
http://familydoctor.org
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.com
REFERENCES:
Arepally GM. Heparin-induced thrombocytopenia. Blood. 2017 May 25;129(21):2864-2872.
Heparin-induced thrombocytopenia (HIT). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/heparin-induced-thrombocytopenia-hit. Updated August 30, 2018. Accessed August 14, 2019.
Heparin sodium. EBSCO Nursing Reference Center website. Available at:https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated September 7, 2018. Accessed August 14, 2019.
Last reviewed August 2019 by EBSCO Medical Review BoardJames P. Cornell, MD Last Updated: 12/13/2019