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Stroke, Vol 20, 1449-1459, Copyright © 1989 by American Heart Association

ARTICLES

Heparin-induced thrombocytopenia

PS Becker and VT Miller
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205-2182.

There are two types of heparin-induced thrombocytopenia. Type I is more common, has an early onset, and is mild, transient, and benign. Type I is due to direct heparin-induced platelet aggregation and is rarely associated with thromboembolic sequela. Type II is infrequent, has a late onset, and is more severe. Type II is due to an immune-mediated platelet aggregation caused by IgG and IgM that becomes bound to platelets. In Type II, the antibody titers decline over several months; however, early reexposure can result in a catastrophic secondary immune response. Frequently, Type II is associated with life- or limb- threatening thromboembolic complications (white clots), including stroke.

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