Delayed-Onset Heparin-Induced Thrombocytopenia
Authors: Lawrence Rice, Walid K. Attisha, John L. Francis
Journal: Annals of Internal Medicine (2003)

Letters4 November 2003Delayed-Onset Heparin-Induced ThrombocytopeniaLawrence Rice, MD, Walid K. Attisha, MD, and John L. Francis, PhDLawrence Rice, MDFrom Baylor College of Medicine; Houston, TX 77030; and Florida Hospital Center for Hemostasis and Thrombosis; Orlando, FL 32804-4603.Search for more papers by this author, Walid K. Attisha, MDFrom Baylor College of Medicine; Houston, TX 77030; and Florida Hospital Center for Hemostasis and Thrombosis; Orlando, FL 32804-4603.Search for more papers by this author, and John L. Francis, PhDFrom Baylor College of Medicine; Houston, TX 77030; and Florida Hospital Center for Hemostasis and Thrombosis; Orlando, FL 32804-4603.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-9-200311040-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We deserve no credit for the muddied waters of heparin-induced thrombocytopenia terminology. The concept of early, mild, nonimmune, clinically inconsequential heparin-induced thrombocytopenia was advanced years ago as heparin-induced thrombocytopenia type 1 (1). In fact, low platelet counts in some hospitalized patients may often be unrelated to heparin and may be due instead to infection, surgery, other drugs, and stresses. The recommendation to designate this as heparin-associated thrombocytopenia to distinguish it from serious heparin-induced thrombocytopenia (2) has not gained wide favor. Furthermore, separating heparin-induced thrombocytopenia from heparin-induced thrombocytopenia with thrombosis syndrome is artificial and misleading, since isolated heparin-induced thrombocytopenia ...References1. Nelson JC, Lerner RG, Goldstein R, Cagin NA. Heparin-induced thrombocytopenia. Arch Intern Med. 1978;138:548-52. [PMID: 637636] CrossrefMedlineGoogle Scholar2. Warkentin TE, Chong BH, Greinacher A. Heparin-induced thrombocytopenia: towards consensus. Thromb Haemost. 1998;79:1-7. [PMID: 9459312] CrossrefMedlineGoogle Scholar3. Lee DH, Warkentin TE. Frequency of heparin-induced thrombocytopenia.. In: Warkentin TE, Greinacher A, eds. Heparin-Induced Thrombocytopenia. 2nd ed. New York: Marcel Dekker; 2001:87-121. Google Scholar4. Bell WR, Royall RM. Heparin-associated thrombocytopenia: a comparison of three heparin preparations. N Engl J Med. 1980;303:902-7. [PMID: 6997743] CrossrefMedlineGoogle Scholar5. Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, . Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332:1330-5. [PMID: 7715641] CrossrefMedlineGoogle Scholar6. Laster J, Silver D. Heparin-coated catheters and heparin-induced thrombocytopenia. J Vasc Surg. 1988;7:667-72. [PMID: 3367431] CrossrefMedlineGoogle Scholar7. Rice L, Huffman DM, Levine ML, Udden MM, Waddell CC, Luper WE. Heparin-induced thrombocytopenia/thrombosis syndrome: clinical manifestation and insights [Abstract]. Blood. 1986;68 Suppl 1 339a. Google Scholar8. Rice L, Kennedy D, Veach A. Pentosan induced cerebral sagittal sinus thrombosis: a variant of heparin induced thrombocytopenia. J Urol. 1998;160:2148. [PMID: 9817346] CrossrefMedlineGoogle Scholar9. Warkentin TE, Sheppard JA, Horsewood P, Simpson PJ, Moore JC, Kelton JG. Impact of the patient population on the risk for heparin-induced thrombocytopenia. Blood. 2000;96:1703-8. [PMID: 10961867] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Baylor College of Medicine; Houston, TX 77030; and Florida Hospital Center for Hemostasis and Thrombosis; Orlando, FL 32804-4603. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDelayed-Onset Heparin-Induced Thrombocytopenia Lawrence Rice , Walid K. Attisha , Alane Drexler , and John L. Francis Delayed-Onset Heparin-Induced Thrombocytopenia John R. De Palma Delayed-Onset Heparin-Induced Thrombocytopenia Robert Kane Metrics Cited byHeparin-Induced ThrombocytopeniaEtiology of thrombocytopenia in all patients treated with heparin products 4 November 2003Volume 139, Issue 9Page: 790-791KeywordsHeparinHeparin-induced thrombocytopeniaLow molecular weight heparinPlateletsProphylaxisProspective studiesPulmonary artery cathetersSurgeryThrombosisVenous thromboembolism ePublished: 4 November 2003 Issue Published: 4 November 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...