Heparin-induced thrombocytopenia differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 30: Line 30:
| Bleeding, thrombosis, skin necrosis.
| Bleeding, thrombosis, skin necrosis.
| Bleeding, thrombosis, petechiae, sepsis.
| Bleeding, thrombosis, petechiae, sepsis.
| Renal failure, hematuria, bleeding.
| Renal failure, hematuria, bleeding, microangiopathic hemolytic anemia.
| Petechiae, bleeding, other autoimmune diseases.
| Petechiae, bleeding, other autoimmune diseases.
| Petechiae, purpura, ecchymoses.
| Petechiae, purpura, ecchymoses.
Line 36: Line 36:
|-
|-
! scope="row" | Platelet count
! scope="row" | Platelet count
| Pain radiates to the trapezius ridge (to the lowest portion of the [[scapula]] on the back) or no radiation.
| Low but usually more than 20000 per microliter.
| Pain radiates to the [[jaw]], or the left or arm, or does not radiate.
| Low.
| Low.
| Low; can be as low as 10000 per microliter.
| Low; can be less than 10000 per microliter; sudden onset after transfusion.
| Variable; usually low.
|-
|-
! scope="row" | PT and PTT
! scope="row" | PT and PTT
Line 57: Line 61:


Table legend: HIT, heparin-induced thrombocytopenia; DIC, disseminated intravascular coagulation; HUS, hemolytic-uremic syndrome; ITP, immune thrombocytopenia purpura; PTP, post-transfusion purpura; SLE, systemic lupus erythematosis
Table legend: HIT, heparin-induced thrombocytopenia; DIC, disseminated intravascular coagulation; HUS, hemolytic-uremic syndrome; ITP, immune thrombocytopenia purpura; PTP, post-transfusion purpura; SLE, systemic lupus erythematosis
==Reference==
==Reference==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 06:43, 13 July 2017

Heparin-induced thrombocytopenia

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Heparin-induced thrombocytopenia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Heparin-induced thrombocytopenia differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Heparin-induced thrombocytopenia differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Heparin-induced thrombocytopenia differential diagnosis

CDC on Heparin-induced thrombocytopenia differential diagnosis

Heparin-induced thrombocytopenia differential diagnosis in the news

Blogs on Heparin-induced thrombocytopenia differential diagnosis

Directions to Hospitals Treating Heparin-induced thrombocytopenia

Risk calculators and risk factors for Heparin-induced thrombocytopenia differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Heparin-induced thrombocytopenia is diagnosed when the platelet count falls by > 50% typically after 5-10 days of heparin therapy. It should be differentiated by other causes of thrombocytopenia like hemolytic uremic syndrome, Thrombotic thrombocytopenia and others.

Differential diagnosis

Diagnosis of Heparin-induced thrombocytopenia is mainly done with the help of lab tests. A decrease in platelet count by > 50% typically after 5-10 days of heparin therapy leads to a diagnosis of HIT. Thus, it should be differentiated from other causes of thrombocytopenia like

The table below summarizes the different findings between HIT and other diseases in the differential diagnosis:

Characteristic/Parameter HIT DIC HUS ITP PTP SLE
Symptoms Bleeding, thrombosis, skin necrosis. Bleeding, thrombosis, petechiae, sepsis. Renal failure, hematuria, bleeding, microangiopathic hemolytic anemia. Petechiae, bleeding, other autoimmune diseases. Petechiae, purpura, ecchymoses. Bleeding, photosensitivity, arthritis, malar rash, discoid rash, renal failure, seizures, psychosis.
Platelet count Low but usually more than 20000 per microliter. Low. Low. Low; can be as low as 10000 per microliter. Low; can be less than 10000 per microliter; sudden onset after transfusion. Variable; usually low.
PT and PTT Does not change the pain Can increase the pain
Systemic systems Pain is worse supine or upon inspiration (breathing in) Not positional
Drug-related Sudden pain, that lasts for hours or sometimes days before a patient comes to the ER Sudden or chronically worsening pain that can come and go in paroxysms or it can last for hours before the patient decides to come to the ER
Bleeding Does not change the pain Can increase the pain

Table legend: HIT, heparin-induced thrombocytopenia; DIC, disseminated intravascular coagulation; HUS, hemolytic-uremic syndrome; ITP, immune thrombocytopenia purpura; PTP, post-transfusion purpura; SLE, systemic lupus erythematosis

Reference

Template:WS Template:WH