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Heparin-induced thrombocytopenia: overview and treatment.

A variety of drugs and disorders can cause thrombocytopenia in patients. Heparin-induced thrombocytopenia (HIT) is considered the most common form of drug-induced thrombocytopenia as well as one of the common causes of thrombocytopenia in hospitalized patients.1,2 Next to bleeding, HIT is the most significant adverse effect associated with heparin therapy. 
 
Two clinical forms of HIT are generally recognized. Type I (heparin-associated thrombocytopenia) occurs in up to 30% of patients receiving heparin. It is a non–immune-mediated reaction often presenting early to exposure (within one to two days) with an asymptomatic, mild-to-moderate transient decline in the platelet count (rarely below 100,000/mcL) with few complications. Resolution is often spontaneous without discontinuation of therapy (Table 1).2 Type II (heparin-induced thrombocytopenia) is the more severe immune-mediated reaction and is the focus of this article. 
 
Table 1 
 
Comparison of Heparin-Induced Thrombocytopenia (HIT I and HIT II)