Heparin-induced thrombocytopenia historical perspective
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Heparin-induced thrombocytopenia |
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Differentiating Heparin-induced thrombocytopenia from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shyam Patel [2]
Overview
The association between heparin and thrombosis with thrombocytopenia was noted in the 1950s. In the 1970s, it was noted that heparin exposure resulted in development of antibodies. In 2000, argatroban became available on the market for treatment of HIT. As of 2012, the American College of Chest Physicians (ACCP) updated their guidelines for management of HIT.
Historical Perspective
- In 1958, Rodger Weissman and Richard Tobin of Hitchcock Memorial Hospital and Dartmouth Medical School describes the phenomenon of HIT.[1] [2] They noted an alarming increase in the incidence of peripheral arterial embolism after systemic heparin therapy.[1] They reported 10 cases of embolism and thrombotic complications after heparin. [1] Emboli were noted in the femoral, popliteal, and cerebral circulation. This seminal study paved the way for future investigations into the pathophysiology of HIT.
- In 1973, Curry and colleagues noted that heparin exposure could lead to development of antibodies.[3] It was suggested that antibody formation was the pathophysiologic basis for HIT. The term "immune" thrombocytopenia was used to describe this phenomenon.[3]
- In 1977, a study by Rhodes and colleagues from Duke University Medical Center described 8 cases of thrombotic and hemorrhagic complications after heparin exposure.[4] These patients were found to have myocardial infarction, pulmonary embolism, and aorto-iliac occlusion.[4] The mean hospital stay was noted to be 54 days, suggesting the severity of the disease at the time. This study proposed discontinuation of heparin as the management strategy, as platelet inhibition did not seem to help.[4]
- In 2000, argatroban was approved by the Food and Drug Administration (FDA) for treatment of HIT. It still remains one of the treatments of choice today.
- In 2012, the American College of Chest Physicians (ACCP) developed the 9th edition of guidelines for management of HIT.
References
- ↑ 1.0 1.1 1.2 WEISMANN RE, TOBIN RW (1958). "Arterial embolism occurring during systemic heparin therapy". AMA Arch Surg. 76 (2): 219–25, discussion 225-7. PMID PMID13497418 Check
|pmid=value (help). - ↑ Lee GM, Arepally GM (2013). "Diagnosis and management of heparin-induced thrombocytopenia". Hematol Oncol Clin North Am. 27 (3): 541–63. doi:10.1016/j.hoc.2013.02.001. PMC 3668315. PMID 23714311.
- ↑ 3.0 3.1 Curry N, Bardana EJ, Pirofsky B (1973). "Heparin sensitivity. Report of a case". Arch Intern Med. 132 (5): 744–5. PMID PMID4201479 Check
|pmid=value (help). - ↑ 4.0 4.1 4.2 Rhodes GR, Dixon RH, Silver D (1977). "Heparin induced thrombocytopenia: eight cases with thrombotic-hemorrhagic complications". Ann Surg. 186 (6): 752–8. PMC 1396502. PMID 603279.