Lower extremity amputation secondary to heparin-associated thrombocytopenia with thrombosis.

A rare cause of limb amputation is heparin-associated thrombocytopenia with thrombosis (HATT). There have been no case reports in the rehabilitation literature of lower extremity amputation secondary to HATT. Three case reports are presented to illustrate how HATT can develop and cause limb ischemia with subsequent amputation. HATT occurs in less than 1% of patients receiving heparin, has an immunological basis for its etiology, and is diagnosed both clinically and with laboratory confirmation. In addition, there are various treatment options, with the most fundamental being cessation of heparin therapy. HATT does present in the rehabilitation setting and physiatrists should be prepared to diagnose and manage it effectively.