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Incidence

• The frequency of HIT is 1-3% in patients receiving unfractionated heparin for 1-2 weeks⁵.



• Despite the high rate of cross-reactivity between UFH and LMWH, it is clear that LMWH is less immunogenic than UFH³.



• Typically, the platelet count begins to fall 4-14 days after starting heparin therapy⁴.



• The total count usually decreases by at least 50% over baseline but rarely falls to levels of 10-20 x 109/L⁴.



• The mean nadir of the count is ~50 x 109/ L⁵. Generally, recovery of the platelet count is only observed when heparin is discontinued⁴.



• When heparin is withdrawn the count returns to normal (> 150 x 109/L) within 4 days (50% of patients) and 7 days in the majority but during this period patients are still at risk of complications¹⁸.



• Occasionally, recovery is only observed after several weeks. Despite low platelet counts and anticoagulant therapy, bleeding complications are rare.

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