RESUMO
The increased use of heparin during the current COVID-19 pandemic has highlighted the risk of a rare but potentially serious complication of heparin therapy, viz. heparin-induced thrombocytopenia (HIT). This is a short review on the pharmacology of heparin and its derivatives, and the pathophysiology of HIT. Guidance on laboratory testing for and clinical management of HIT is presented in accordance with international guidelines. There are important similarities and differences between HIT and the new entity of vaccine-induced immune thrombotic thrombocytopenia, also known as thrombosis with thrombocytopenia syndrome, which clinicians need to be aware of.
Assuntos
Anticoagulantes/efeitos adversos , COVID-19 , Heparina/efeitos adversos , Trombocitopenia/induzido quimicamente , Anticoagulantes/administração & dosagem , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Heparina/administração & dosagem , Humanos , Trombocitopenia/diagnóstico , Trombocitopenia/fisiopatologiaRESUMO
There have recently been safety concerns regarding an increased risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) following administration of SARS-CoV-2 adenoviral vector vaccines. The Southern African Society of Thrombosis and Haemostasis reviewed the emerging literature on this idiosyncratic complication. A draft document was produced and revised by consensus agreement by a panel of professionals from various specialties. The recommendations were adjudicated by independent international experts to avoid local bias. We present concise, practical guidelines for the clinical management of VITT.
