Talk:Heparin-induced thrombocytopenia

Latest comment: 3 years ago by Jfdwolff in topic Treatment
Good articleHeparin-induced thrombocytopenia has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Article milestones
DateProcessResult
January 1, 2010Good article nomineeListed

Synchronize with Thrombocytopenia

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cross posted Thrombocytopenia#Heparin-induced thrombocytopenia and thrombosis (HITT) should be synchronized with Heparin-induced thrombocytopenia#Treatment, and summarize it. Could an expert do this please? --Hroðulf (or Hrothulf) (Talk) 09:12, 22 May 2008 (UTC)Reply

Spontaneous form

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Four patients with spontaneous HIT: doi:10.1016/j.amjmed.2008.03.012. Primary research but possibly worth mentioning. JFW | T@lk 12:16, 26 June 2008 (UTC)Reply

ACCP

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ACCP guideline doi:10.1378/chest.08-0677 JFW | T@lk 01:14, 3 October 2008 (UTC)Reply

Sources

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Once I get around to improving this article, I intend to use the following sources:

Let's see what happens. JFW | T@lk 22:30, 23 November 2008 (UTC)Reply

Rewriting

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I don't usually do this, but today I had to refactor some content that was standing in the way: here. Much of the content was unsourced despite making numerical claims, and most of the sources were primary sources. Finally, much of the content was highly technical. I will be populating sections per WP:MEDMOS in due course. Please bear with me. JFW | T@lk 22:16, 25 November 2008 (UTC)Reply

Beware of antiphospholipids

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doi:10.1111/j.1538-7836.2009.03335.x JFW | T@lk 23:24, 23 July 2009 (UTC)Reply

NEJM 2006

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I had completely overlooked:

Arepally GM, Ortel TL (2006). "Clinical practice. Heparin-induced thrombocytopenia". N. Engl. J. Med. 355 (8): 809–17. doi:10.1056/NEJMcp052967. PMID 16928996. {{cite journal}}: Unknown parameter |month= ignored (help)

Let's see if I can get hold of it. JFW | T@lk 12:57, 9 August 2009 (UTC)Reply

Treatment

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As usual this article has been lying fallow because I was too chicken to write a good "treatment" section. I think we need to cover all three licensed anticoagulants, their monitoring and drawbacks. Perhaps a bit about the troubles about setting the target for lepirudin. JFW | T@lk 23:18, 8 September 2009 (UTC)Reply

Could use some images of this condition

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Similar to [1] or [2] Doc James (talk · contribs · email) 08:47, 15 December 2009 (UTC)Reply

Haven't seen any. Have you got a few? JFW | T@lk 20:09, 15 December 2009 (UTC)Reply
No it is no very common. Will keep my eyes open a get a picture when possible. That uptodate article I sent you expands a bit of epidemiology. As we switch over to LMWH HIT will be less common.Doc James (talk · contribs · email) 20:14, 15 December 2009 (UTC)Reply
Warkentin is a bit more cautious about LMWH being less HIT-ogenic. The last case I treated was due to dalteparin. JFW | T@lk 23:38, 22 December 2009 (UTC)Reply

GA Review

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The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.


This review is transcluded from Talk:Heparin-induced thrombocytopenia/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Triplestop x3 18:27, 17 December 2009 (UTC)Reply

The sources appear to be reliable, and the coverage good. However I still see problems involving the clarity of this page.

The following parts of the lead may be confusing to the reader.

  • Heparin-induced thrombocytopenia (HIT) without or with thrombosis (HITT) - This seems awfully shorthand, you should probably make this more clear.
  • Shouldn't the term HIT be defined as an "immune mediated adverse drug reaction" that causes x y and z?
  • "unfractionated" or "low molecular weight" Would it not be sufficient for the lead just to say due to the administration certain forms of the anticoagulant (blood clotting inhibitor) heparin?

Symptoms section looks fine.

The mechanism section:

  • This section suddenly dives into a discussion on the presence of anti-bodies, however this is not summarized in the lead. It needs a more logical flow. The first two sentences sound irrelevant.
  • To make matters more complicated, the most commonly used other anticoagulant, warfarin, is contraindicated in this setting as there is a very high risk of warfarin necrosis; this is the development of skin gangrene in those receiving warfarin or a similar vitamin K inhibitor. If the patient was receiving warfarin at the time when HIT is diagnosed, the activity of warfarin is reversed with vitamin K. -- This part sounds unclear. Does having HIT make it more likely for one to develop skin gangrene with Warfarin? What does adding Vitamin K do to help?

I'm going to go ahead and pass this. Sorry for the delay, as I was trying to get a third opinion. My biggest concern is the prose quality however I believe that this article is good enough for GA. Triplestop x3 21:27, 1 January 2010 (UTC)Reply

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Heparin IS natural, and found in the human body

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I saw that the article mentioned that heparin is not naturally occurring, but that is obviously false. I cited my edit. I'm not a Wikipedia person, hope I did it right. 68.46.171.223 (talk) —Preceding undated comment added 00:11, 22 February 2010 (UTC).Reply

The problem is that your edit introduced a non-sequitur. Pharmacological heparin is clearly immunogenic and your edit doesn't explain that. Please revise your contribution. JFW | T@lk 19:58, 22 February 2010 (UTC)Reply

RIETE

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A very large data set (RIETE) shows UFH indeed carries a higher risk than LMWH. doi:10.1111/j.1538-7836.2011.04402.x JFW | T@lk 07:49, 21 September 2011 (UTC)Reply

The report does not seem to discuss confirmation of the diagnosis with anti-PF4 or serotonin release assays. JFW | T@lk 07:52, 21 September 2011 (UTC)Reply

Paper to follow up

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doi:10.1111/j.1538-7836.2011.04536.x is an ISTH working group report on standards in HITT diagnosis. Accepted for publication, but still a bit raw to be cited. JFW | T@lk 22:37, 18 October 2011 (UTC)Reply

doi:10.1111/bjh.12059 is the new version of the British guidelines. May need to review those and update the article. JFW | T@lk 21:42, 15 October 2012 (UTC)Reply
doi:10.1111/jth.12153 is a systematic review on HIT in children. Again pre-publication, but seems MEDRS and needs following up/incorporation. JFW | T@lk 16:49, 30 January 2013 (UTC)Reply
doi:10.1056/NEJMct1206642 NEJM review on treatment. JFW | T@lk 07:08, 21 February 2013 (UTC)Reply

New NEJM review

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FYI, a new review in NEJM is out, with some good info such as the use of fondaparinux for treatment; probably a good time to update the treatment section anyways, now that Lepirudin is off the market. Yobol (talk) 01:26, 22 April 2013 (UTC)Reply

I wish I had time for it. Perhaps in a little while I can update the article and get it to FA at the same time. JFW | T@lk 21:04, 29 April 2013 (UTC)Reply

Criteria

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Recommendations for standardization of laboratory testing for drug-induced immune thrombocytopenia: communication from the SSC of the ISTH doi:10.1111/jth.12852 JFW | T@lk 21:27, 25 January 2015 (UTC)Reply

NEJM

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Greinacher review: doi:10.1056/NEJMcp1411910 JFW | T@lk 08:05, 16 July 2015 (UTC)Reply

Immunology

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Heparin-protamine antibodies doi:10.1111/jth.13405 JFW | T@lk 07:03, 7 July 2016 (UTC)Reply

JTH review

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doi:10.1111/jth.13813 JFW | T@lk 11:59, 7 November 2017 (UTC)Reply

Treatment

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Systematic review doi:10.1182/bloodadvances.2020002963 JFW | T@lk 11:28, 15 April 2021 (UTC)Reply