Newer strategies for the treatment of heparin-induced thrombocytopenia

Treatment with heparin is associated with two types of thrombocytopenia. On e is a mild, transient, nonimmune disorder, generally without adverse clini cal consequence. The other, known as heparin-induced thrombocytopenia (HIT) , is a potentially serious, immunoglobulin-mediated reaction with a paradox ic high risk of thromboembolic events. Various treatment options for HIT ar e discussed, with emphasis on pharmacologic approaches that control the inc reased thrombin generation characteristic of this disorder.