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  1. Cook, Howard C. Jr RPh, BCNSP, FASHP


This article offers an overview of the pathophysiology, diagnosis, and treatment of heparin-induced thrombocytopenia (HIT). This disorder is an immune-mediated reduction of platelets with subsequently increased generation of thrombin and increased risk of arterial and venous thrombosis. Heparin-induced thrombocytopenia can occur as an isolated incident or with acute thrombosis (HIT with thrombosis syndrome [HITTS]). Proper recognition, cessation of all forms of heparin (and compounds that cross-react with heparin), and rapid initiation of nonheparin anticoagulation are essential steps in reducing the risk of death, limb amputation, and new thrombotic events. Current alternatives to heparin are reviewed.