play_arrow

Podcasting

Heparin Induced Thrombotic Thrombocytopenia Syndrome

Dr Swapnil Pawar April 9, 2023 74


Background
share close
  • cover play_arrow

    Heparin Induced Thrombotic Thrombocytopenia Syndrome
    Dr Swapnil Pawar

HITT’s

Written by Dr Andrew Lam

Four T’s Score

0 +1 +2
Thrombocytopenia Platelet decrease <30% OR nadir <10 Platelet decrease 30-50% OR nadir 10 – 19 Platelet decrease >50% AND nadir > 20
Timing of Thrombocytopenia Platelet Fall < 4 days without recent exposure Unclear onset within 5-10 days, onset after day 10 OR Platelet Fall < 1 Day with prior heparin exposure within 30-100 days Clear onset within 5-10 days OR Platelet Fall < 1 Day with prior heparin exposure within 30 days
Thrombosis None Progressive or recurrent thrombosis, non-necrotising skin lesions or suspected thrombosis New thrombosis or skin necrosis

Systemic Reaction post-IV Heparin

Other Causes Definite Possible None appreciable

 

0-3 Points (Low Probability) – 1% Risk of HITT’s

4-5 Points (Intermediate Probability) – 10% Risk of HITT’s

6-8 Points (High Probability) – 50% Risk of HITT’s

Laboratory Investigations for HITT’s

Immunoassay (e.g. ELISA)

  • Detects the presence of PF4-Heparin antibodies
  • Higher incidence of false positive rates than functional assays (may detect clinically insignificant antibodies)
  • Results are reported as a titre level (higher the concentration of antibodies, higher risk of HITT’s

Functional Assays

  • Tests the ability of a PF4-heparin antibody to bind and activate platelets
  • More resource-intensive and require more expertise to perform and interpret
  • Results are reported as positive or negative

 

Rate it
Previous episode
Medspresso Podcast
play_arrow
share playlist_add
close
  • 71

Podcasting

von-Willebrand Disease

Dr Swapnil Pawar February 22, 2023

play_arrow von-Willebrand Disease Dr Swapnil Pawar Written by Dr Andrew Lam Von-Willebrand Disease Types of Von-Willebrand Disease Type 1 – Characterised by reduced levels of VWF, and is associated with […]

Read more trending_flat