Heparin-induced thrombocytopenia diagnostic criteria

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Heparin-induced thrombocytopenia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]


Overview

Diagnostic Criteria

The 4T score

The current diagnostic algorithm for HIT involves calculation of the pre-test probability using the 4T score. This scoring system is used when a patient is found to have thrombocytopenia or thrombosis after heparin exposure. It is calculated before the heparin-PF4 IgG antibody is ordered, and it offers a cost-effective and efficient way for determining the likelihood of HIT.[1]

  • Thrmobocytopenia
  • Thrombosis
  • Timing
  • oTher


[2]

  • 0 to 3 points: low probability
  • 4 to 5 points: intermediate probability
  • 6 to 8 points: high probability

The American Society of Hematology, as part of the Choosing Wisely program, states[3]:

"Don’t test or treat for suspected heparin-induced thrombocytopenia (HIT) in patients with a low pre-test probability of HIT."


Reference

  1. ↑ Gardiner EE, Andrews RK, Cuker A (2014). "DiagnoSTic assays for heparin-induced thrombocytopenia". Br J Haematol. 166 (5): 631–3. doi:10.1111/bjh.12940. PMC 4134688. PMID 24824208.
  2. ↑ Cuker A, Gimotty PA, Crowther MA, Warkentin TE (2012). "Predictive value of the 4Ts scoring system for heparin-induced thrombocytopenia: a systematic review and meta-analysis". Blood. 120 (20): 4160–7. doi:10.1182/blood-2012-07-443051. PMC 3501714. PMID 22990018.
  3. ↑ The American Society of Hematology. test or treat for suspected heparin-induced thrombocytopenia (HIT) in patients with a low pre-test probability of HIT.. 2014

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