*Temple University Hospital, Philadelphia, PA. Dr. Mateen is now with Hackensack University Medical Center, Hackensack, NJ.
†Columbus Regional Health, Columbus, IN.
J Am Podiatr Med Assoc. 2023 Jul-Aug;113(4). doi: 10.7547/21-014.
Heparin-induced thrombocytopenia (HIT) is a prothrombotic state caused by the buildup of platelet factor 4 antibodies with decreased platelet count caused by heparin therapeutic or prophylactic therapy. It is important to detect this complication, especially in critically ill patients and cardiac patients. Detection of HIT can be demonstrated by positive antibodies in a HIT panel. Based on clinical and laboratory findings, heparin use should be discontinued with immediate transition to alternative anticoagulation therapies. Thromboembolic events can be an adverse effect of HIT and can cause local tissue necrosis, especially in the lower extremity. This case is a retrospective medical record review of a 52-year-old man who was initially admitted as an outpatient for coronary artery bypass grafting and mitral valve replacement who developed digital gangrene from HIT. This case emphasizes the rare adverse effects of HIT and the need for timely consultation for surgical treatment of limb ischemia/gangrene.
肝素诱导的血小板减少症（HIT）是一种由血小板因子 4 抗体积聚引起的血栓前状态，由肝素治疗或预防治疗引起血小板计数减少。重要的是要检测到这种并发症，特别是在危重症患者和心脏患者中。通过 HIT 面板中的阳性抗体可以检测到 HIT。根据临床和实验室发现，应停止肝素使用，并立即过渡到替代抗凝治疗。血栓栓塞事件可能是 HIT 的不良反应，并可能导致局部组织坏死，特别是在下肢。本病例是对一名 52 岁男性的回顾性病历回顾，他最初因冠状动脉旁路移植术和二尖瓣置换术作为门诊患者入院，因 HIT 导致手指坏疽。本病例强调了 HIT 的罕见不良反应以及需要及时咨询以进行肢体缺血/坏疽的手术治疗。
