Heparin-induced thrombocytopenia risk factors: Difference between revisions
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* Race: African Americans are more prone to HIT than Caucasians.<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> | * Race: African Americans are more prone to HIT than Caucasians.<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> | ||
* There is no increase in risk of HIT with genetic risk factors for thrombosis such as [[factor V Leiden]], [[prothrombin]] gene mutation, [[methylenetetrahydrofolate reductase]] ([[MTHFR]]) polymorphism and platelet-receptor polymorphisms. | * There is no increase in risk of HIT with genetic risk factors for thrombosis such as [[factor V Leiden]], [[prothrombin]] gene mutation, [[methylenetetrahydrofolate reductase]] ([[MTHFR]]) polymorphism and platelet-receptor polymorphisms. | ||
* Polymorphisms in the [[crystallized fragment]] (Fc) gamma receptor have been suggested to play in role in the risk for HIT. It is presumed that high affinity receptors result in stronger IgG binding to platelet membranes, allowing for the release of procoagulants. | |||
'''Protective''' risk factors include: | '''Protective''' risk factors include: | ||
Revision as of 21:58, 6 July 2017
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Heparin-induced thrombocytopenia |
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Differentiating Heparin-induced thrombocytopenia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Heparin-induced thrombocytopenia risk factors On the Web |
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American Roentgen Ray Society Images of Heparin-induced thrombocytopenia risk factors |
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Directions to Hospitals Treating Heparin-induced thrombocytopenia |
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Risk calculators and risk factors for Heparin-induced thrombocytopenia risk factors |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Aric C. Hall, M.D., [3] Shyam Patel [4]
Overview
Heparin-induced thrombocytopenia is diagnosed when the platelet count falls by > 50% typically after 5-10 days of heparin therapy. Increased risks for heparin-induced thrombocytopenia depends on type of heparin (unfractionated heparin > low molecular weight heparin), duration of therapy, females and type of patients (commoner in surgical patients that require large amount of heparin)
Risk factors
Adverse risk factors include:[1]
- Duration of heparin treatment: A long duration of heparin expsosure, such as 2 weeks, is associated with the greatest risk.
- Type of heparin: unfractionated heparin (UFH) has a greater risk than low molecular weight heparin (LMWH.
- Type of patient: surgical patients are at higher risk than medical; cardiac surgical patients have the highest risk of all.[2] This is though to be related to differences in basal level of circulating platelet factor 4 (PF4) and platelet activation in these various populations.
- Sex: Females have a higher risk than males. The odds ratio (OR) is 2.4:1.[2]
- Race: African Americans are more prone to HIT than Caucasians.[2]
- There is no increase in risk of HIT with genetic risk factors for thrombosis such as factor V Leiden, prothrombin gene mutation, methylenetetrahydrofolate reductase (MTHFR) polymorphism and platelet-receptor polymorphisms.
- Polymorphisms in the crystallized fragment (Fc) gamma receptor have been suggested to play in role in the risk for HIT. It is presumed that high affinity receptors result in stronger IgG binding to platelet membranes, allowing for the release of procoagulants.
Protective risk factors include:
- Type of warfarin: Use of low molecular weight heparin such as enoxaparin carries a lower risk for HIT.
- Type of patient: Pediatric or obstetric patients have a lower risk for HIT than medical or surgical patients.
Reference
- ↑ Warkentin TE, Sheppard JA, Sigouin CS, Kohlmann T, Eichler P, Greinacher A. Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia. Blood 2006;108:2937-41. PMID 16857993.
- ↑ 2.0 2.1 2.2 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.