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Heparin induced thrombocytopenia - Coggle Diagram
Heparin induced thrombocytopenia
Types
UFH
large polysacceride
ATIII
Xa
IIa (thrombin)
APTT monitoring
Cleared reticuloendothelial system
LMWH
short chain polysacceride
Limited IIa activity
lower risk
HIT
Osteoprosis
Renally excreted
Differential fo APTT rise
Haemophilia
A =VIII
B = IX
Factor deficiency
XI
XII
Antiphospholipid
Artefact
HIT
Type 1
Non immune mediated
Common
Occurs early in treatment
Resolves spontaneously
Types 2
Immune mediated
IgG to platelet factor 4
Thrombosis
0.6%patients treated with heparin
5-10days post exposure
Diagnosis of HIT
4T score
Thrombocytopenia
Timing
Thrombosis
oTher causes
Each scored out of 2, greater than 6 high risk
Immunoassay
Management
Withdrawel of heparin
Alternative anticoagulation
Argabatran direct thrombin inhibtior
Dabigatran (direct thrombin inhibitor)
Adioid giving platelets
Avioid warfarin
May worsen skin necrosis