The platelet count rarely goes below 100000 l often becomes normal despite further heparin administration and is generally without clinical sequelae this benign form of heparin induced thrombocytopenia hit attributed to a direct interaction between administered heparin and circulating platelets is classified as hit type i . The primary clinical presentation of hit is thrombocytopenia usually with a 50 decline in platelets below 150 x 10 9 l in most patients this may occur immediately following heparin exposure rapid presentation or up to 3 weeks following exposure delayed presentation. Type ii heparin induced thrombocytopenia hit is a potentially severe adverse effect of heparin treatment triggered by an immune response although most cases occur in patients receiving unfractioned heparin hit can also arise after low molecular weight heparin lmwh. Heparin induced thrombocytopenia is a transient development of antibodies to heparin while the condition carries a high risk for morbidity and mortality early detection and prompt treatment can greatly reduce the associated risk to life and limb this is the fourth article in the series heparin induced thrombocytopenia
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