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However, a subset of HIT sera recognise PF4 bound to platelet chondroitin sulfate; these antibodies activate platelets in vitro and in vivo even in the absence of heparin, thus explaining: delayed-onset HIT (where HIT begins or worsens after stopping heparin); persisting HIT (where HIT takes several weeks to recover); spontaneous HIT syndrome (a disorder clinically and serologically resembling HIT but without proximate heparin exposure); and fondaparinux-associated HIT (four distinct syndromes featuring thrombocytopenia that begins or worsens during treatment with fondaparinux), with a new patient case presented with ongoing thrombocytopenia (and fatal haemorrhage) during treatment of HIT with fondaparinux, with fondaparinux-dependent platelet activation induced by patient serum (\u201cfondaparinux cross-reactivity\u201d). Ironically, despite existence of fondaparinux-associated HIT, this pentasaccharide anticoagulant is a frequent treatment for HIT (including one used by the author). HIT can be confused with other disorders, including those with a) timing similar to HIT (e. g. abciximab-associated thrombocytopenia of delayed-onset); b) combined thrombocytopenia\/thrombosis (e. g. symmetrical peripheral gangrene secondary to acute DIC and shock liver); and c) both timing of onset and thrombosis (e. g. warfarin-associated venous limb gangrene complicating cancer-associated DIC). By understanding clinical and pathophysiological similarities and differences between HIT and non-HIT mimicking disorders, the clinician is better able to make the correct diagnosis.<\/jats:p>","DOI":"10.1160\/th16-06-0435","type":"journal-article","created":{"date-parts":[[2016,9,22]],"date-time":"2016-09-22T08:18:51Z","timestamp":1474532331000},"page":"813-822","source":"Crossref","is-referenced-by-count":64,"title":["Clinical picture of heparin-induced thrombocytopenia (HIT) and its differentiation from non-HIT thrombocytopenia"],"prefix":"10.1160","volume":"116","author":[{"given":"Theodore E.","family":"Warkentin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2017,11,30]]},"reference":[{"key":"10.1160\/TH16-06-0435-1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2011.04322.x"},{"key":"10.1160\/TH16-06-0435-2","doi-asserted-by":"crossref","unstructured":"Warkentin TE. 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