Medicina Universitaria (Jul 2021)
Understanding heparin-induced thrombosis: A brief review
Abstract
Heparin has been the first line for treatment and prevention of thrombosis for a while. However, one of its non-hemorrhagic effects remains noticeable: heparin-induced thrombocytopenia, mediated by antibodies directed to complexes of platelet factor, and heparin. Binding to platelet FcγRIIA receptors initiates platelet aggregation and its thrombotic effect. Incidence of heparin-induced thrombocytopenia (HIT) ranges from <0.1% to 7%. Diagnosis can be made clinically in patients with thrombocytopenia/thrombosis currently on heparin. Treatment includes suspension of heparin and the administration of non-heparin anticoagulants. Vaccine-induced thrombocytopenia/thrombosis is a complication described after administering vaccines developed to prevent severe coronavirus disease (severe acute respiratory syndrome coronavirus 2). It has a remarkable resemblance to HIT. Therefore, they have been studied clustered. Enzyme-linked immunosorbent assays, a modified platelet-activation test, are used for its diagnosis. Treatment consists of early administration of high-dose intravenous immunoglobulin in conjunction with non-heparin anticoagulation.
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