Heparin Induced Thrombocytopenia

Abstract

Increased heparin tolerance and recurrent thromboembolism which included myocardial infarction (3 patients), pulmonary embolism (2 patients) and complete aorto-iliac occlusion (2 patients), heralded development of thrombocytopenia between the 8th and 12th day of heparin therapy in 6 women and 2 men. Thrombocytopenia persisted until heparin was discontinued. Bleeding (cerebral hemorrhage) was the initial complication in 1 patient and occurred in conjunction with thrombotic complications in 4 other patients. Agglutination absorption testing in 1 and complement fixation testing in 5 patients suggested the presence of heparin dependent antiplatelet antibodies. After platelet recovery, 4 of the 8 patients responded to parenteral heparin rechallenge with rapid decreases in their platelet counts. Early recognition of the syndrome with cessation of heparin therapy is imperative for the successful management of afflicted patients.