Question

What are some of the positive and negative factors associated with Heparin-induced Thrombocytopenia? Why has there been resistance to adopt Heparin-induced Thrombocytopenia and what are some ways you could propose to increase utilization of Heparin-induced Thrombocytopenia ?

Answer 1

Ans- Heparin-induced Thrombocytopenia or HIT is a prothrombic disorder caused by abnormal antobodies to complex of platelet factor-4 and heparin, an anticoagulant.Heparin binds PF-4 are the hallmark of HIT.HIT is a majur cause of morbadity and mortality in patients treated with heparin.

HIT antibodies found in plasma.HIT antibodies recognise PF-4 platelet chondroitin sulfate.These antibodies may cause platelet activation by cross-linking FcγIIA receptors which increase the release and surface expression of PF-4.

Activated platelet creating a positive feedback for release of PF-4 .

heparin resistance caused by-

• antithrombin defeciency.
• increased in heparin binding protein
• high levels og fibrinogen
• elevation heparin clearance

patients with HIT at high rish for thrombotic require an anticoagulations with antothrombotic agent that does not react with Heparin-PF4 antibodies-

Lepirudin-an anticoagulant which acts as diresct thrombin inhibitor.Lepirudin is analogue of hirudin.

Argatroban

Bivalirudin

Danaparoid

Fondaparinux (Arixtra)

Warfarin