HEPARIN-INDUCED THROMBOCYTOPENIA

• Pathological Basis:
  • Almost all patients who receive heparin show a transient decrease in platelet count after heparin administration. This transient decrease may be due to platelet aggregation and sequestration by the spleen.
  • More striking decreases in platelet count are often seen after several days of heparin administration. Two possible mechanisms are involved: heparin-induced antibody formation (most common), and heparin-induced thrombosis with DIC.
  • This complication appears to occur more frequently in patients receiving bovine lung heparin than in those receiving porcine mucosal preparation of heparin.
• Treatment:
  • Discontinue heparin, may switch to heparin of different tissue origin.
  • Start oral anticoagulant therapy.