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__NOTOC__
{{Heparin-induced thrombocytopenia}}
{{Heparin-induced thrombocytopenia}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com] {{shyam}}
 
==Overview==
==Overview==
[[Heparin-induced thrombocytopenia]] is diagnosed when the [[platelet]] count falls by > 50% typically after 5-10 days of [[heparin]] therapy. It has been found to occur with increased frequencies in females, white population and patients over age of 60 years. An episode of [[Heparin-induced thrombocytopenia]] increases risks for other future thrombo-embolic events.
Worldwide, the [[prevalence]] of HIT (in persons exposed to [[heparin]]) ranges from a low of 200 per 100,000 persons to a high of 5,000 per 100,000 persons. In pediatric populations, the prevalence of HIT (in persons exposed to [[heparin]]) ranges from a low of 1,500 per 100,000 persons to a high of 3,700 per 100,000 persons with an average prevalence of 2,600 per 100,000 persons. In [[neonatal]] populations, the prevalence of HIT (in persons exposed to [[heparin]]) is as low as 330 per 100,000 persons. HIT is more prevalent in the African American race than the Caucasian race and occurs more commonly in females compared to males.


==Epidemiology and demographics==
==Epidemiology and demographics==
===Mortality===
===Prevalence===
* [[Heparin-induced thrombocytopenia]] is diagnosed when the [[platelet]] count falls by > 50% typically after 5-10 days of [[heparin]] therapy. The affected individuals have an increased risks of having another thromboembolic event (20-50% increased risks)
*Worldwide, the [[prevalence]] of HIT (in persons exposed to [[heparin]]) ranges from a low of 200 per 100,000 persons to a high of 5,000 per 100,000 persons.<ref name="pmid20059332">{{cite journal| author=Arepally GM, Ortel TL| title=Heparin-induced thrombocytopenia. | journal=Annu Rev Med | year= 2010 | volume= 61 | issue=  | pages= 77-90 | pmid=20059332 | doi=10.1146/annurev.med.042808.171814 | pmc=4153429 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20059332  }} </ref><ref name="pmid25444534">{{cite journal| author=Obeng EA, Harney KM, Moniz T, Arnold A, Neufeld EJ, Trenor CC| title=Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system. | journal=J Pediatr | year= 2015 | volume= 166 | issue= 1 | pages= 144-50 | pmid=25444534 | doi=10.1016/j.jpeds.2014.09.017 | pmc=4274245 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25444534  }} </ref>
* Mortality rate can be as high as 20%
*In pediatric populations, the [[prevalence]] of HIT (in persons exposed to [[heparin]]) ranges from a low of 1,500 per 100,000 persons to a high of 3,700 per 100,000 persons with an average prevalence of 2,600 per 100,000 persons.<ref name="pmid25444534">{{cite journal| author=Obeng EA, Harney KM, Moniz T, Arnold A, Neufeld EJ, Trenor CC| title=Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system. | journal=J Pediatr | year= 2015 | volume= 166 | issue= 1 | pages= 144-50 | pmid=25444534 | doi=10.1016/j.jpeds.2014.09.017 | pmc=4274245 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25444534  }} </ref> The prevalence is 1-3% in children exposed to [[unfractionated heparin]] and undergoing [[cardiac surgery]].<ref name="pmid23118656">{{cite journal| author=Vakil NH, Kanaan AO, Donovan JL| title=Heparin-induced thrombocytopenia in the pediatric population: a review of current literature. | journal=J Pediatr Pharmacol Ther | year= 2012 | volume= 17 | issue= 1 | pages= 12-30 | pmid=23118656 | doi=10.5863/1551-6776-17.1.12 | pmc=3428184 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23118656  }} </ref>
* 1 in 10 patients suffer from other morbidities (amputations or other arterial venous or both thrombo-embolic events)
*In neonatal populations, the [[prevalence]] of HIT (in persons exposed to [[heparin]]) is as low as 330 per 100,000 persons.<ref name="pmid25444534">{{cite journal| author=Obeng EA, Harney KM, Moniz T, Arnold A, Neufeld EJ, Trenor CC| title=Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system. | journal=J Pediatr | year= 2015 | volume= 166 | issue= 1 | pages= 144-50 | pmid=25444534 | doi=10.1016/j.jpeds.2014.09.017 | pmc=4274245 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25444534  }} </ref>
 
===Case Fatality Rate===
*The [[case fatality rate]] of HIT is 20-30% for patients who develop [[thrombosis]].<ref name="pmid16202170">{{cite journal| author=Franchini M| title=Heparin-induced thrombocytopenia: an update. | journal=Thromb J | year= 2005 | volume= 3 | issue=  | pages= 14 | pmid=16202170 | doi=10.1186/1477-9560-3-14 | pmc=1262784 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16202170  }} </ref>
*For patients who have HIT but do not develop [[thrombosis]], the case [[fatality rate]] is unknown but is lower than 20-30%.<ref name="pmid16202170">{{cite journal| author=Franchini M| title=Heparin-induced thrombocytopenia: an update. | journal=Thromb J | year= 2005 | volume= 3 | issue=  | pages= 14 | pmid=16202170 | doi=10.1186/1477-9560-3-14 | pmc=1262784 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16202170  }} </ref>
 
===Age===
*The adult population is more prone to development of HIT than the [[Pediatrics|pediatric]] population. Please see the Prevalence section above for the [[prevalence]] of HIT in pediatric and [[neonatal]] populations.


===United States of America===
===Gender===
* Incidence varies from 1-5%.
*Females are more commonly affected with HIT than males. The female to male ratio is approximately 2.4 to 1.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311  }} </ref> This is thought to be related to higher predilection for [[autoimmune]] tendencies in females compared to males.


===Race===
===Race===
Some studies have shown that the incidences of [[heparin-induced thrombocytopenia]] (HIT) are commoner among white patients compared to non-white patients.
*HIT is more prevalent in the African American race than the Caucasian race.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311  }} </ref>


===Sex===
===Developed Countries===
Female have increased risks compared to male for heparin-induced thrombocytopenia
HIT has a major impact on society in developed countries. Development of HIT can lead to high [[morbidity]] and [[mortality]] in hospitals and can increase health care costs. For example, the development of [[thrombotic]] complications can lead to the need for prolonged [[Anticoagulant|anticoagulation]] and monitoring, which places a burden on the healthcare system.


===Age===
===Developing Countries===
Risks for development of HIT Increases with age (>60years)
There is minimal data on HIT in developing countries. There is no variation in [[prevalence]] of HIT in developing countries.


==Reference==
==Reference==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Drugs]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Up-To-Date]]
 
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Latest revision as of 15:07, 8 August 2018

Heparin-induced thrombocytopenia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2] Shyam Patel [3]

Overview

Worldwide, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 200 per 100,000 persons to a high of 5,000 per 100,000 persons. In pediatric populations, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 1,500 per 100,000 persons to a high of 3,700 per 100,000 persons with an average prevalence of 2,600 per 100,000 persons. In neonatal populations, the prevalence of HIT (in persons exposed to heparin) is as low as 330 per 100,000 persons. HIT is more prevalent in the African American race than the Caucasian race and occurs more commonly in females compared to males.

Epidemiology and demographics

Prevalence

  • Worldwide, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 200 per 100,000 persons to a high of 5,000 per 100,000 persons.[1][2]
  • In pediatric populations, the prevalence of HIT (in persons exposed to heparin) ranges from a low of 1,500 per 100,000 persons to a high of 3,700 per 100,000 persons with an average prevalence of 2,600 per 100,000 persons.[2] The prevalence is 1-3% in children exposed to unfractionated heparin and undergoing cardiac surgery.[3]
  • In neonatal populations, the prevalence of HIT (in persons exposed to heparin) is as low as 330 per 100,000 persons.[2]

Case Fatality Rate

Age

  • The adult population is more prone to development of HIT than the pediatric population. Please see the Prevalence section above for the prevalence of HIT in pediatric and neonatal populations.

Gender

  • Females are more commonly affected with HIT than males. The female to male ratio is approximately 2.4 to 1.[5] This is thought to be related to higher predilection for autoimmune tendencies in females compared to males.

Race

  • HIT is more prevalent in the African American race than the Caucasian race.[5]

Developed Countries

HIT has a major impact on society in developed countries. Development of HIT can lead to high morbidity and mortality in hospitals and can increase health care costs. For example, the development of thrombotic complications can lead to the need for prolonged anticoagulation and monitoring, which places a burden on the healthcare system.

Developing Countries

There is minimal data on HIT in developing countries. There is no variation in prevalence of HIT in developing countries.

Reference

  1. ↑ Arepally GM, Ortel TL (2010). "Heparin-induced thrombocytopenia". Annu Rev Med. 61: 77–90. doi:10.1146/annurev.med.042808.171814. PMC 4153429. PMID 20059332.
  2. ↑ 2.0 2.1 2.2 Obeng EA, Harney KM, Moniz T, Arnold A, Neufeld EJ, Trenor CC (2015). "Pediatric heparin-induced thrombocytopenia: prevalence, thrombotic risk, and application of the 4Ts scoring system". J Pediatr. 166 (1): 144–50. doi:10.1016/j.jpeds.2014.09.017. PMC 4274245. PMID 25444534.
  3. ↑ Vakil NH, Kanaan AO, Donovan JL (2012). "Heparin-induced thrombocytopenia in the pediatric population: a review of current literature". J Pediatr Pharmacol Ther. 17 (1): 12–30. doi:10.5863/1551-6776-17.1.12. PMC 3428184. PMID 23118656.
  4. ↑ 4.0 4.1 Franchini M (2005). "Heparin-induced thrombocytopenia: an update". Thromb J. 3: 14. doi:10.1186/1477-9560-3-14. PMC 1262784. PMID 16202170.
  5. ↑ 5.0 5.1 Lee GM, Arepally GM (2013). "Diagnosis and management of heparin-induced thrombocytopenia". Hematol Oncol Clin North Am. 27 (3): 541–63. doi:10.1016/j.hoc.2013.02.001. PMC 3668315. PMID 23714311.

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