Heparin-Induced Thrombocytopenia after Severe Injury in an Aged Woman: Using Clinical Scoring System

A 75-year-old Japanese woman with severe injury suffered from immune-mediated heparin-induced thrombocytopenia (HIT) due to the use of unfractionated heparin for maintaining the arterial line. Testing for the HIT IgG antibody and a functional assay assessed by the platelet microparticle method confirmed the diagnosis of HIT. The 4Ts clinical scoring system was useful for predicting HITin this patient. Our case confirmed that severe injury may indeed be a risk factor for development of HIT, and demonstrated that only a small amount of heparin can induce HIT. We should be aware of the possibility of iatrogenic thrombocytopenia and thromboembolism (called HIT) in severely injured patients and should act accordingly without delay.

Keywords: Heparin-induced thrombocytopenia, severe injury, clinical scoring system, direct oral anticoagulants.