Heparin-Induced Thrombocytopenia: A Focus on Thrombosis.

Abstract

Heparin-induced thrombocytopenia is an immune-mediated disorder caused by antibodies that recognize complexes of platelet factor 4 and heparin. Thrombosis is a central and unpredictable feature of this syndrome. Despite optimal management, disease morbidity and mortality from thrombosis remain high. The hypercoagulable state in heparin-induced thrombocytopenia is biologically distinct from other thrombophilic disorders in that clinical complications are directly attributable to circulating ultra-large immune complexes. In some individuals, ultra-large immune complexes elicit unchecked cellular procoagulant responses that culminate in thrombosis. To date, the clinical and biologic risk factors associated with thrombotic risk in heparin-induced thrombocytopenia remain elusive. This review will summarize our current understanding of thrombosis in heparin-induced thrombocytopenia with attention to its clinical features, cellular mechanisms, and its management.

• Authors: Gowthami M Arepally, Anand Padmanabhan
• Journal: Arteriosclerosis, thrombosis, and vascular biology (Arterioscler Thromb Vasc Biol) Vol. 41 Issue 1 Pg. 141-152 (01 2021) ISSN: 1524-4636 [Electronic] United States
• PMID: 33267665 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)

Chemical References

• Antibodies
• Anticoagulants
• Antithrombins
• Factor Xa Inhibitors
• PF4 protein, human
• Platelet Factor 4
• Heparin

Topics

• Animals
• Antibodies (blood)
• Anticoagulants (administration & dosage, immunology)
• Antithrombins (therapeutic use)
• Blood Coagulation (drug effects)
• Factor Xa Inhibitors (therapeutic use)
• Heparin (adverse effects, immunology)
• Humans
• Platelet Factor 4 (immunology)
• Risk Factors
• Thrombocytopenia (blood, chemically induced, drug therapy, immunology)
• Thrombosis (blood, chemically induced, drug therapy, immunology)