Chittal Abhinandan R, Kumar Ajay, Rao Shiavax J, Lakra Pallavi, Nacu Natalia
Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2022 Jul 4;12(4):102-106. doi: 10.55729/2000-9666.1081. eCollection 2022.
Heparin Induced Thrombocytopenia (HIT) is a life threatening condition which is caused due to antibody formation following exposure to heparin or heparin products. It occurs due to the formation of Platelet Factor 4 antibodies (PF4). HIT is classified into 3 categories based on the duration between heparin exposure and onset of drop in platelet counts. A less common form of HIT is delayed onset HIT which occurs more than 9 days after exposure to heparin or heparin products. In this report we would like to present a rare case of delayed onset HIT which occurred in our patient who presented with rhabdomyolysis and Non ST elevation myocardial infraction (NSTEMI); which resulted in limb ischemia which needed to be treated by amputation of the affected area. We also highlight further management of patients who have thrombotic disease in the setting of HIT and review literature of how heparin or heparin products can be reintroduced in such patient who cannot be managed by other anticoagulation.
肝素诱导的血小板减少症（HIT）是一种危及生命的疾病，它是由于接触肝素或肝素产品后形成抗体所致。它是由于血小板因子4抗体（PF4）的形成而发生的。根据肝素暴露与血小板计数下降开始之间的持续时间，HIT分为3类。一种不太常见的HIT形式是迟发性HIT，它发生在接触肝素或肝素产品9天之后。在本报告中，我们想介绍一例发生在我们患者身上的罕见迟发性HIT病例，该患者表现为横纹肌溶解和非ST段抬高型心肌梗死（NSTEMI）；这导致肢体缺血，需要对受影响区域进行截肢治疗。我们还强调了HIT背景下血栓性疾病患者的进一步管理，并回顾了关于如何在无法通过其他抗凝治疗的此类患者中重新引入肝素或肝素产品的文献。
