clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2026-104-2-95-103clinmed-1382Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESГепарин-индуцированная тромбоцитопения: лабораторная диагностика, лечение, профилактикаHeparin-induced thrombocytopenia: laboratory diagnosis, treatment, preventionhttps://orcid.org/0000-0002-8255-4159СугралиевА. Б.SugrаliyevA. B.

Сугралиев Ахметжан Бегалиевич — канд. мед. наук, ассоциированный профессор, заведующий кафедрой внутренних болезней.

Алматы

Akhmetzhan B. Sugrаliyev — candidate of medical sciences; associate professor, Head of Internal Diseases department.

Almaty

Asugraliyev@gmail.comhttps://orcid.org/0000-0001-7818-4952ЧириллоП.CirilloP.

Плинио Чирилло — профессор отделения кардиологии, кафедры передовых биомедицинских наук.

Неаполь

Plinio Cirillo — MD PhD, professor of Department of Advanced Biomedical Sciences, Division of Cardiology.

Naples

Казахский Национальный медицинский университет им. С.Д. АсфендияроваКазахстанAsfendiyarov Kazakh National Medical UniversityKazakhstanНеаполитанский университет Федерико IIИталияUniversity of Naples Federico IIItaly202619042026104295103Copyright © Сугралиев А.Б., Чирилло П., 20262026Сугралиев А.Б., Чирилло П.Sugrаliyev A.B., Cirillo P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1382

Гепарин-индуцированная тромбоцитопения (ГИТ) — протромботическое заболевание, вызванное антителами к комплексам тромбоцитарного фактора 4 (PF4) и гепарина. ГИТ — это потенциально опасное для жизни клиническое состояние, которое необходимо подозревать у пациентов с тромбозами с тромбоцитопенией на фоне применения любых форм гепарина более 4 суток. В случае установленного диагноза ГИТ необходимо помнить об опасности дальнейшего применения любых форм гепарина. Для диагностики ГИТ необходимо использовать международные критерии «4Тs», которые позволяют своевременно предсказать высокую вероятность данного заболевания. Диагноз ГИТ требует верификации с помощью специальных лабораторных тестов. Иммуноферментный анализ и функциональные анализы крови с оценкой активности тромбоцитов на фоне гепарина позволяют верифицировать диагноз ГИТ. Наш опыт внедрения ИФА для диагностики ГИТ показал высокую стоимость проведения данного анализа при относительно низкой частоте встречаемости ГИТ в условиях одной больницы. Следовательно, требуется создание региональных лабораторных хабов, которые необходимы в масштабах крупного города. Негепариновые антикоагулянты, которые ингибируют образование тромбина, включая прямые пероральные антикоагулянты, составляют основу лечения тромботических осложнений ГИТ. При ГИТ нежелательно применение варфарина как альтернативного антикоагулянта до полного восстановления количества тромбоцитов. Проведен обзор литературы в медицинских ресурсах e-Library, Pubmed, Web of Science, Scopus, посвященных вопросам диагностики, лечения и профилактики с использованием ключевых слов.

Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. HIT is a potentially life-threatening clinical condition that should be suspected in patients with thrombosis with thrombocytopenia after 4 days of heparin treatment. In case of an established diagnosis of HIT, it is necessary to stop heparin treatment. The ‘‘4 T’s’’ criteria of HIT has been recommended to be used in patients with clinical suspicion of HIT. The diagnosis of HIT requires verification using special laboratory tests to confirm the diagnosis. ELISA and functional blood tests with platelet activity assessment in patient on heparin treatment allow verifying the diagnosis of HIT. Our experience in implementing ELISA for the diagnosis of HIT has shown the high cost of this analysis with a relatively low incidence of HIT in a single hospital. Therefore, it is necessary to create a regional laboratory hub, which is necessary on the scale of a large city. Non-heparin anticoagulants that inhibit thrombin formation, including direct oral anticoagulants (DOACs) are cornerstones of treatment of thrombotic complications of HIT. Warfarin should not be used until the platelet count has recovered. A literature review was conducted in the medical resources e-Library, Pubmed, Web of Science, Scopus dedicated to diagnosis, treatment and prevention using keywords

гепарин-индуцированная тромбоцитопениямониторирование количества тромбоцитовальтернативные антикоагулянтыпрямые пероральные антикоагулянтыпрофилактикаheparin-induced thrombocytopeniaplatelet count monitoringalternative anticoagulantsdirect oral anticoagulantspreventionИсследование не имело спонсорской поддержкиThe study had no sponsorshipReferencesСугралиев А.Б. Гепарин-индуцированная тромбоцитопения. Кардиология. 2024;64(5):18-25. DOI: 10.18087/cardio.2024.5.n2186Sugraliev A.B. Heparin-induced thrombocytopenia. Cardiology. 2024;64(5):18-25. (In Russ.). DOI: 10.18087/cardio.2024.5.n2186Cuker A., Arepally G.M., Chong B.H., Cines D.B., Greinacher A., Gruel Y. et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood. Adv. (2018) 2:3360–92. DOI: 10.1182/bloodadvances.2018024489Cuker A., Arepally G.M., Chong B.H., Cines D.B., Greinacher A., Gruel Y. et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood. Adv. (2018) 2:3360–92. DOI: 10.1182/bloodadvances.2018024489Cuker A., Arepally G., Crowther M.A. et al. The HIT Expert Probability (HEP) Score: A novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion. J. Thromb. Haemost. 2010;8:2642–50. DOI: 10.1111/j.1538–7836.2010.04059.x.Cuker A., Arepally G., Crowther M.A. et al. The HIT Expert Probability (HEP) Score: A novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion. J. Thromb. Haemost. 2010;8:2642–50. DOI: 10.1111/j.1538–7836.2010.04059.x.Cuker A., Gimotty P.A., Crowther M.A., Warkentin T.E. Predictive value of the 4Ts scoring system for heparin-induced thrombocytopenia: a systematic review and meta-analysis. Blood. 2012;120(20):4160–7. DOI: 10.1182/blood-2012-07-443051Cuker A., Gimotty P.A., Crowther M.A., Warkentin T.E. Predictive value of the 4Ts scoring system for heparin-induced thrombocytopenia: a systematic review and meta-analysis. Blood. 2012;120(20):4160–7. DOI: 10.1182/blood-2012-07-443051Watson H., Davidson S., Keeling D. Guidelines on the diagnosis and management of heparin-induced thrombocytopenia: second edition. Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology. Br. J. Haematol. 2012;159(5):528–40. DOI: 10.1111/bjh.12059.Watson H., Davidson S., Keeling D. Guidelines on the diagnosis and management of heparin-induced thrombocytopenia: second edition. Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology. Br. J. Haematol. 2012;159(5):528–40. DOI: 10.1111/bjh.12059.Jang I.K., Hursting M.J. When heparins promote thrombosis: review of heparin induced thrombocytopenia. Circulation. 2005;111:2671–83. DOI: 10.1161/CIRCULATIONAHA.104.518563Jang I.K., Hursting M.J. When heparins promote thrombosis: review of heparin induced thrombocytopenia. Circulation. 2005;111:2671–83. DOI: 10.1161/CIRCULATIONAHA.104.518563Ahmed I., Majeed A., Powel R. Heparin induced thrombocytopenia: diagnosis and management update l. Postgrad. Med. J. 2007;83:575–582. DOI: 10.1136/pgmj.2007.059188Ahmed I., Majeed A., Powel R. Heparin induced thrombocytopenia: diagnosis and management update l. Postgrad. Med. J. 2007;83:575–582. DOI: 10.1136/pgmj.2007.059188Lee G.M., Arepally G.M. Heparin-induced thrombocytopenia. Hematology Am. Soc. Educ. Program. 2013;2013:668–74. DOI: 10.1182/asheducation-2013.1.668Lee G.M., Arepally G.M. Heparin-induced thrombocytopenia. Hematology Am. Soc. Educ. Program. 2013;2013:668–74. DOI: 10.1182/asheducation-2013.1.668Meyer O., Salama A., Pittet N., Schwind P. Rapid detection of heparin-induced platelet antibodies with particle gel immunoassay (ID-HPF4). Lancet. 1999;354(9189):1525–6. DOI: 10.1016/S01406736(99)03625-9Meyer O., Salama A., Pittet N., Schwind P. Rapid detection of heparin-induced platelet antibodies with particle gel immunoassay (ID-HPF4). Lancet. 1999;354(9189):1525–6. DOI: 10.1016/S01406736(99)03625-9Baroletti S., Hurwitz S., Conti N.A. et al. Thrombosis in suspected heparin-induced thrombocytopenia occurs more often with high antibody levels. Am. J. Med. 2012;125(1):44–9. DOI: 10.1016/j.amjmed.2011.06.025Baroletti S., Hurwitz S., Conti N.A. et al. Thrombosis in suspected heparin-induced thrombocytopenia occurs more often with high antibody levels. Am. J. Med. 2012;125(1):44–9. DOI: 10.1016/j.amjmed.2011.06.025Berry C., Tcherniantchouk O., Ley EJ. et al. Overdiagnosis of heparin-induced thrombocytopenia in surgical ICU patients. J. Am. Coll. Surg. 2011;213(1):10–7; discussion 17–8 DOI: 10.1016/j.jamcollsurg.2011.04.002Berry C., Tcherniantchouk O., Ley EJ. et al. Overdiagnosis of heparin-induced thrombocytopenia in surgical ICU patients. J. Am. Coll. Surg. 2011;213(1):10–7; discussion 17–8 DOI: 10.1016/j.jamcollsurg.2011.04.002Harada M.Y., Hoang D.M., Zaw A.A. et al. Overtreatment of Heparin-Induced Thrombocytopenia in the Surgical ICU. Crit. Care Med. 2017;45(1):28-34. DOI: 10.1097/CCM.0000000000002002Harada M.Y., Hoang D.M., Zaw A.A. et al. Overtreatment of Heparin-Induced Thrombocytopenia in the Surgical ICU. Crit. Care Med. 2017;45(1):28-34. DOI: 10.1097/CCM.0000000000002002Whitlatch N.L, Kong D.F, Metjian A.D, Arepally G.M, Ortel T.L. Validation of the high-dose heparin confirmatory step for the diagnosis of heparin-induced thrombocytopenia. Blood. 2010;116(10):1761–6. DOI: 10.1182/blood-2010-01-262659Whitlatch N.L, Kong D.F, Metjian A.D, Arepally G.M, Ortel T.L. Validation of the high-dose heparin confirmatory step for the diagnosis of heparin-induced thrombocytopenia. Blood. 2010;116(10):1761–6. DOI: 10.1182/blood-2010-01-262659Sheridan D., Carter C., Kelton J.G. A diagnostic test for heparin-induced thrombocytopenia. Blood. 1986;67(1):27–30. DOI: 10.1182/blood.V67.1.27.27Sheridan D., Carter C., Kelton J.G. A diagnostic test for heparin-induced thrombocytopenia. Blood. 1986;67(1):27–30. DOI: 10.1182/blood.V67.1.27.27Eichler P., Raschke R., Lubenow N. et al. The new ID-heparin/PF4 antibody test for rapid detection of heparin-induced antibodies in comparison with functional and antigenic assays. Br. J. Haematol. 2002;116(4):887–91. DOI: 10.1046/j.0007-1048.2002.03363.xEichler P., Raschke R., Lubenow N. et al. The new ID-heparin/PF4 antibody test for rapid detection of heparin-induced antibodies in comparison with functional and antigenic assays. Br. J. Haematol. 2002;116(4):887–91. DOI: 10.1046/j.0007-1048.2002.03363.xArepally G., Reynolds C., Tomaski A., et al. Comparison of PF4/ heparin ELISA assay with the 14C-serotonin release assay in the diagnosis of heparin-induced thrombocytopenia. Am. J. Cli.n Pathol. 1995;104(6):648–54. DOI: 10.1093/ajcp/104.6.648Arepally G., Reynolds C., Tomaski A., et al. Comparison of PF4/ heparin ELISA assay with the 14C-serotonin release assay in the diagnosis of heparin-induced thrombocytopenia. Am. J. Cli.n Pathol. 1995;104(6):648–54. DOI: 10.1093/ajcp/104.6.648Jang I.K., Hursting M.J. When heparins promote thrombosis: review of heparin induced thrombocytopenia. Circulation. 2005;111:2671–83. DOI: 10.1161/CIRCULATIONAHA.104.518563Jang I.K., Hursting M.J. When heparins promote thrombosis: review of heparin induced thrombocytopenia. Circulation. 2005;111:2671–83. DOI: 10.1161/CIRCULATIONAHA.104.518563Warkentin T.E, Greinacher A. Heparin-induced thrombocytopenia: recognition,treatment, and prevention. Chest. 2004;126:311S–37S. DOI: 10.1378/chest.126.3_suppl.311SWarkentin T.E, Greinacher A. Heparin-induced thrombocytopenia: recognition,treatment, and prevention. Chest. 2004;126:311S–37S. DOI: 10.1378/chest.126.3_suppl.311SKeeling D., Davidson S., Watson H. Guideline: the management of heparin induced thrombocytopenia. Br. J. Haematol. 2006;133:259–69. DOI: 10.1111/j.1365-2141.2006.06018.xKeeling D., Davidson S., Watson H. Guideline: the management of heparin induced thrombocytopenia. Br. J. Haematol. 2006;133:259–69. DOI: 10.1111/j.1365-2141.2006.06018.xGreinacher A., Eichler P., Lubenow N. et al. Heparin-induced thrombocytopenia with thromboembolic complications: meta-analysis of 2 prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood. 2000;96:846–51. DOI: 10.1182/blood.V96.3.846Greinacher A., Eichler P., Lubenow N. et al. Heparin-induced thrombocytopenia with thromboembolic complications: meta-analysis of 2 prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood. 2000;96:846–51. DOI: 10.1182/blood.V96.3.846Klein H.G., Bell W.R. Disseminated intravascular coagulation during heparin therapy. Ann. Intern. Med. 1974;80:477–81. DOI: 10.7326/0003-4819-80-4-477Klein H.G., Bell W.R. Disseminated intravascular coagulation during heparin therapy. Ann. Intern. Med. 1974;80:477–81. DOI: 10.7326/0003-4819-80-4-477Keeling D.M., Richards E.M., Baglin T.P. Platelet aggregation in response to four low molecular weight heparins and the heparinoid ORG 10172 in patients with heparin-induced thrombocytopenia. Br. J. Haematol. 1994;86:425–6. DOI: 10.1111/j.1365-2141.1994.tb04760.xKeeling D.M., Richards E.M., Baglin T.P. Platelet aggregation in response to four low molecular weight heparins and the heparinoid ORG 10172 in patients with heparin-induced thrombocytopenia. Br. J. Haematol. 1994;86:425–6. DOI: 10.1111/j.1365-2141.1994.tb04760.xChong B.H., Gallus A.S., Cade J.F. For the Australian HIT Study Group. Prospective randomised open-label comparison of danaparoid with dextran 70 in the treatment of heparin-induced thrombocytopaenia with thrombosis: a clinical outcome study. Thromb. Haemost. 2001;86:1170–5. DOI: 10.1055/s-0037-1616046Chong B.H., Gallus A.S., Cade J.F. For the Australian HIT Study Group. Prospective randomised open-label comparison of danaparoid with dextran 70 in the treatment of heparin-induced thrombocytopaenia with thrombosis: a clinical outcome study. Thromb. Haemost. 2001;86:1170–5. DOI: 10.1055/s-0037-1616046Greinacher A., Eichler P., Lubenow N. et al. Heparin-induced thrombocytopenia with thromboembolic complications: meta-analysis of 2 prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood. 2000;96:846–51. DOI: 10.1182/blood.V96.3.846Greinacher A., Eichler P., Lubenow N. et al. Heparin-induced thrombocytopenia with thromboembolic complications: meta-analysis of 2 prospective trials to assess the value of parenteral treatment with lepirudin and its therapeutic aPTT range. Blood. 2000;96:846–51. DOI: 10.1182/blood.V96.3.846Lewis B.E., Wallis D.E., Berkowitz S.D. for the ARG-911 Study Investigators. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation. 2001;103:1838–43. DOI: 10.1161/01.cir.103.14.1838Lewis B.E., Wallis D.E., Berkowitz S.D. for the ARG-911 Study Investigators. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia. Circulation. 2001;103:1838–43. DOI: 10.1161/01.cir.103.14.1838Boshkov L.K., Warkentin T.E., Hayward C.P. et al. Heparin-induced thrombocytopenia and thrombosis: clinical and laboratory studies. Br. J. Haematol. 1993;84:322–8. DOI: 10.1111/j.1365-2141.1993.tb03072.xBoshkov L.K., Warkentin T.E., Hayward C.P. et al. Heparin-induced thrombocytopenia and thrombosis: clinical and laboratory studies. Br. J. Haematol. 1993;84:322–8. DOI: 10.1111/j.1365-2141.1993.tb03072.xLubenow N., Eichler P., Lietz T. et al. Lepirudin for prophylaxis of thrombosis in patients with acute isolated heparin-induced thrombocytopenia: an analysis of three prospective studies. Blood. 2004;104:3072–7. DOI: 10.1182/blood-2004-02-0621Lubenow N., Eichler P., Lietz T. et al. Lepirudin for prophylaxis of thrombosis in patients with acute isolated heparin-induced thrombocytopenia: an analysis of three prospective studies. Blood. 2004;104:3072–7. DOI: 10.1182/blood-2004-02-0621Vanholder R., Camez A., Veys N. et al. Pharmacokinetics of recombinant hirudin in hemodialyzed end-stage renal failure patients. Thromb. Haemost. 1997;77:650–5. DOI: 10.1055/s-0038-1656028Vanholder R., Camez A., Veys N. et al. Pharmacokinetics of recombinant hirudin in hemodialyzed end-stage renal failure patients. Thromb. Haemost. 1997;77:650–5. DOI: 10.1055/s-0038-1656028Eichler P., Friesen H.J., Lubenow N. et al. Antihirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT and clinical relevance. Blood 2000;96:2373–8. DOI: 10.1182/blood.V96.7.2373Eichler P., Friesen H.J., Lubenow N. et al. Antihirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT and clinical relevance. Blood 2000;96:2373–8. DOI: 10.1182/blood.V96.7.2373Greinacher A., Lubenow N., Eichler P. Anaphylactic and anaphylactoid reactions associated with lepirudin in patients with heparin-induced thrombocytopenia. Circulation. 2003;108:2062–5. DOI: 10.1161/01.CIR.0000096056.37269.14Greinacher A., Lubenow N., Eichler P. Anaphylactic and anaphylactoid reactions associated with lepirudin in patients with heparin-induced thrombocytopenia. Circulation. 2003;108:2062–5. DOI: 10.1161/01.CIR.0000096056.37269.14Keng T.B., Chong B.H. Heparin-induced thrombocytopenia and thrombosis syndrome: in vivo cross-reactivity with danaparoid and successful treatment with r-Hirudin. Br. J. Haematol. 2001;114:394–396. DOI: 10.1046/j.1365-2141.2001.02943.xKeng T.B., Chong B.H. Heparin-induced thrombocytopenia and thrombosis syndrome: in vivo cross-reactivity with danaparoid and successful treatment with r-Hirudin. Br. J. Haematol. 2001;114:394–396. DOI: 10.1046/j.1365-2141.2001.02943.xKodityal S., Manhas A.H., Udden M. et al. Danaparoid for heparin-induced thrombocytopenia: an analysis of treatment failures. Eur. J. Haematol. 2003;71:109–113. DOI: 10.1034/j.16000609.2003.00105.xKodityal S., Manhas A.H., Udden M. et al. Danaparoid for heparin-induced thrombocytopenia: an analysis of treatment failures. Eur. J. Haematol. 2003;71:109–113. DOI: 10.1034/j.16000609.2003.00105.xFarner B., Eichler P., Kroll H. et al. A comparison of danaparoid and lepirudin in heparin-induced thrombocytopenia. Thromb. Haemost. 2001;85:950–7. DOI: 10.1055/s-0037-1615946Farner B., Eichler P., Kroll H. et al. A comparison of danaparoid and lepirudin in heparin-induced thrombocytopenia. Thromb. Haemost. 2001;85:950–7. DOI: 10.1055/s-0037-1615946Lewis B.E., Matthai W.H., Cohen M. et al. Argatroban anticoagulation during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Cath. Cardiovasc. Interv. 2002;57:177–84. DOI: 10.1002/ccd.10276Lewis B.E., Matthai W.H., Cohen M. et al. Argatroban anticoagulation during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Cath. Cardiovasc. Interv. 2002;57:177–84. DOI: 10.1002/ccd.10276Kuo K.H.M, Kovacs M.J. Fondaparinux: a potential new therapy for HIT. Hematology. 2005;10(4):271-5. DOI: 10.1080/10245330500093492Kuo K.H.M, Kovacs M.J. Fondaparinux: a potential new therapy for HIT. Hematology. 2005;10(4):271-5. DOI: 10.1080/10245330500093492Lori-Ann Linkins L.A., Hu G., Warkentin T.E. Systematic review of fondaparinux for heparin-induced thrombocytopenia: When there are no randomized controlled trials. Res. Pract. Thromb. Haemost. 2018;2:678–683. DOI: 10.1002/rth2.12145Lori-Ann Linkins L.A., Hu G., Warkentin T.E. Systematic review of fondaparinux for heparin-induced thrombocytopenia: When there are no randomized controlled trials. Res. Pract. Thromb. Haemost. 2018;2:678–683. DOI: 10.1002/rth2.12145Skelley J.W., Kyle J.A., Roberts R.A. Novel oral anticoagulants for heparin-induced thrombocytopenia. J. Thromb. Thrombolysis. 2016;42(2):172–8. DOI: 10.1007/s11239-016-1365-0Skelley J.W., Kyle J.A., Roberts R.A. Novel oral anticoagulants for heparin-induced thrombocytopenia. J. Thromb. Thrombolysis. 2016;42(2):172–8. DOI: 10.1007/s11239-016-1365-0Carré J., Guérineau H., Le Beller C., Mauge L., Huynh B., Nili R. et al. Direct Oral Anticoagulants as Successful Treatment of Heparin-Induced Thrombocytopenia: A Parisian Retrospective Case Series. Front. Med. 2001;8:713649. DOI: 10.3389/fmed.2021.713649Carré J., Guérineau H., Le Beller C., Mauge L., Huynh B., Nili R. et al. Direct Oral Anticoagulants as Successful Treatment of Heparin-Induced Thrombocytopenia: A Parisian Retrospective Case Series. Front. Med. 2001;8:713649. DOI: 10.3389/fmed.2021.713649Warkentin T.E., Pai M., Linkins L.A. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review. Blood. 2017;130(9):1104–1113 DOI: 10.1182/blood-2017-04-778993Warkentin T.E., Pai M., Linkins L.A. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review. Blood. 2017;130(9):1104–1113 DOI: 10.1182/blood-2017-04-778993Gruel Y., De Maistre E., Pouplard C., Mullier F., Susen S., Roullet S. et al. Members of the French Working Group on Perioperative Haemostasis Groupe d’intérêt en hémostase périopératoire GIHP Diagnosis and management of heparin-induced thrombocytopenia. Anaesth. Crit. Care. Pain Med. 2020;39:291–310. DOI: 10.1016/j.accpm.2020.03.012Gruel Y., De Maistre E., Pouplard C., Mullier F., Susen S., Roullet S. et al. Members of the French Working Group on Perioperative Haemostasis Groupe d’intérêt en hémostase périopératoire GIHP Diagnosis and management of heparin-induced thrombocytopenia. Anaesth. Crit. Care. Pain Med. 2020;39:291–310. DOI: 10.1016/j.accpm.2020.03.012Bittl J.A., Chaitman B.R., Feit F. et al. Bivalirudin versus heparin during coronary angioplasty for unstable or postinfarction angina: final report reanalysis of the Bivalirudin Angioplasty Study. Am. Heart J. 2001;142:952–9. DOI: 10.1067/mhj.2001.119374Bittl J.A., Chaitman B.R., Feit F. et al. Bivalirudin versus heparin during coronary angioplasty for unstable or postinfarction angina: final report reanalysis of the Bivalirudin Angioplasty Study. Am. Heart J. 2001;142:952–9. DOI: 10.1067/mhj.2001.119374Pinto D.S., Sperling R.T., Tu R.M. et al. Combination platelet glycoprotein IIb/IIIa receptor and lepirudin administration during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Cath. Cardiovasc. Interv. 2003;58:65–8. DOI: 10.1002/ccd.10393Pinto D.S., Sperling R.T., Tu R.M. et al. Combination platelet glycoprotein IIb/IIIa receptor and lepirudin administration during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Cath. Cardiovasc. Interv. 2003;58:65–8. DOI: 10.1002/ccd.10393Warkentin T.E. High-dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review. Expert. Rev. Hematol. 2019;12(8):685–698. DOI: 10.1080/17474086.2019.1636645Warkentin T.E. High-dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review. Expert. Rev. Hematol. 2019;12(8):685–698. DOI: 10.1080/17474086.2019.1636645Linkins L.A., Dans A.L., Moores L.K. et al. Treatment and Prevention of Heparin-Induced Thrombocytopenia Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST. 2012; 141(2):e495S–e530S. DOI: 10.1378/chest.11-2303Linkins L.A., Dans A.L., Moores L.K. et al. Treatment and Prevention of Heparin-Induced Thrombocytopenia Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST. 2012; 141(2):e495S–e530S. DOI: 10.1378/chest.11-2303

The authors declare that there are no conflicts of interest present.