{"id":2495,"date":"2009-03-08T17:23:49","date_gmt":"2009-03-08T17:23:49","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/hemhit\/"},"modified":"2025-05-14T19:09:57","modified_gmt":"2025-05-14T19:09:57","slug":"hemhit","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/hemhit\/","title":{"rendered":"Criterios Diagn\u00f3stico para Trombocitopenia Inducida por Heparina (HIT)"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<p style=\"font-weight: 400;\"><strong>Criterios Diagn\u00f3stico para Trombocitopenia Inducida por Heparina (HIT)<\/strong><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Exposici\u00f3n a heparina\u00a0&gt;5\u00a0d\u00edas<\/li>\n<li>Trombocitopenia relativa: descenso del recuento de plaquetas del 50% del basal O trombocitopenia absoluta: descenso del recuento de plaquetas a menos de 100 a 150 x 10<sup>9<\/sup>\/L<\/li>\n<li>Ausencia de otras causas de trombocitopenia<\/li>\n<li>Desarrollo de nuevas trombosis, o extensi\u00f3n de trombosis preexistentes, a pesar de estar recibiendo tratamiento con heparina<\/li>\n<li>Confirmaci\u00f3n por pruebas de laboratorio<\/li>\n<li>Retorno a un recuento plaquetario normal cuando la heparina es discontinuada<\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p style=\"font-weight: 400;\"><strong>Pruebas serol\u00f3gicas para determinar un HIT<\/strong>\u00a0(listados en orden de mayor a menor sensibilidad)<\/p>\n<ul style=\"font-weight: 400;\">\n<li>Prueba\u00a0de\u00a0liberaci\u00f3n\u00a0de\u00a0serotonina<\/li>\n<li>ELISA Heparina\/PF 4 (factor plaquetario 4)<\/li>\n<li>Agregaci\u00f3n plaquetaria<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\"><strong>Estimaci\u00f3n de la probabilidad pretest de HIT: Las \u00abCuatro T\u00bb<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td rowspan=\"2\" width=\"144\"><\/td>\n<td colspan=\"3\" width=\"432\">Puntos (0, 1, o 2 por cada una de las 4 categor\u00edas: Puntuaci\u00f3n m\u00e1xima posible = 8)<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: center;\" width=\"144\">2<\/td>\n<td style=\"text-align: center;\" width=\"144\">1<\/td>\n<td style=\"text-align: center;\" width=\"144\">0<\/td>\n<\/tr>\n<tr>\n<td width=\"144\">Trombocitopenia<\/td>\n<td width=\"144\">Ca\u00edda de plaquetas &gt;50% o nadir &gt;\/= 20<\/td>\n<td width=\"144\">Ca\u00edda de plaquetas 30\u201350%, o nadir 10-19<\/td>\n<td width=\"144\">Ca\u00edda de plaquetas &lt;30%, o nadir &lt;10<\/td>\n<\/tr>\n<tr>\n<td width=\"144\">Tiempo* de comienzo de la ca\u00edda de plaquetas (u otras secuelas del HIT)<\/td>\n<td width=\"144\">D\u00edas 5\u201310, o &lt;\/= d\u00eda 1 con heparina reciente (pasado 30 d\u00edas)<\/td>\n<td width=\"144\">&gt;10 d\u00edas o tiempo no establecido; o &lt;d\u00eda 1 con heparina reciente \u00a0(pasados 31\u2013100 d\u00edas)<\/td>\n<td width=\"144\">&lt;D\u00eda 4 (no heparina reciente)<\/td>\n<\/tr>\n<tr>\n<td width=\"144\">Trombosis\u00a0u\u00a0otras secuelas<\/td>\n<td width=\"144\">Nueva trombosis probada, necrosis cut\u00e1nea; o reacci\u00f3n sist\u00e9mica aguda despu\u00e9s de la administraci\u00f3n en bolo de HNF<\/td>\n<td width=\"144\">Trombosis progresiva o recurrente; lesiones eritematosas en piel; trombosis sospechada (no probada)<\/td>\n<td width=\"144\">No<\/td>\n<\/tr>\n<tr>\n<td width=\"144\">Otra(s) causa(s) de descenso de plaquetas<\/td>\n<td width=\"144\">Sin\u00a0evidencia<\/td>\n<td width=\"144\">Posible<\/td>\n<td width=\"144\">Definitiva<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"font-weight: 400;\">HNF,\u00a0heparina\u00a0no\u00a0fraccionada<br \/>\nScore de probabilidad pretest: 6\u20138 indica elevado; 4\u20135, intermedio; y 0\u20133, bajo.<br \/>\n*El primer d\u00eda de exposici\u00f3n a la heparina es considerada el d\u00eda 0.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\"><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol style=\"font-weight: 400;\">\n<li>Warkentin TE, Aird WC, Rand JH. Platelet-endothelial interactions: sepsis, HIT, and antiphospholipid syndrome. Hematology (Am Soc Hematol Educ Program). 2003;:497-519. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/14633796\/\">[Medline]<\/a><\/li>\n<li>Warkentin TE, Cook DJ. Heparin, low molecular weight heparin, and heparin-induced thrombocytopenia in the ICU. Crit Care Clin. 2005 Jul;21(3):513-29. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15992671\/\">[Medline]<\/a><\/li>\n<li>Greinacher A. CLINICAL PRACTICE. Heparin-Induced Thrombocytopenia. N Engl J Med. 2015 Jul 16;373(3):252-61. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26176382\/\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p style=\"font-weight: 400;\">Creado: Sep 22, 2005.<br \/>\nActualizado: Sep 28, 2016.<\/p>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Criterios Diagn\u00f3stico para Trombocitopenia Inducida por Heparina (HIT) Exposici\u00f3n a heparina\u00a0&gt;5\u00a0d\u00edas Trombocitopenia relativa: descenso del recuento de plaquetas del 50% del basal O trombocitopenia absoluta: descenso del recuento de plaquetas a menos de 100 a 150 x 109\/L Ausencia de otras causas de trombocitopenia Desarrollo de nuevas trombosis, o extensi\u00f3n de trombosis preexistentes, a pesar [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[171],"tags":[1348,16,15,14,13,1381,1515,1514,1513,960,959,1512,1511],"class_list":["post-2495","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-cardiology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-hematology","tag-heparin","tag-heparina","tag-hit","tag-induced","tag-inducida","tag-thrombocytopenia","tag-trombocitopenia"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2495","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2495"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2495\/revisions"}],"predecessor-version":[{"id":9158,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2495\/revisions\/9158"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2495"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2495"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2495"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}