John R. Bartholomew, MD Section of Vascular Medicine, Department of Cardiovascular Medicine and the Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, Ohio
Susan M. Begelman, MD Section of Vascular Medicine, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
Amjad AlMahameed, MD Section of Vascular Medicine, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
Correspondence: John R. Bartholomew, MD, Section of Vascular Medicine, S60, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195; barthoj@ccf.org
Dr. Bartholomew is a consultant for The Medicines Company and on the speakers' bureau of GlaxoSmithKline.
Dr. Begelman is a consultant for and on the speakers' bureau of GlaxoSmithKline.
Dr. AlMahameed has indicated that he has nothing to disclose.
ABSTRACT
Heparin-induced thrombocytopenia (HIT) is a potentially devastating complication of therapy with either unfractionated or low-molecular-weight heparin. Thrombocytopenia is no longer essential for the diagnosis of HIT, since a 50% drop in the platelet count may be a more specific indicator. Once HIT is clinically suspected, heparin should be stopped immediately and direct thrombin inhibitor therapy started; waiting for laboratory confirmation may be catastrophic.
