{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:14Z","timestamp":1783509314611,"version":"3.55.0"},"reference-count":17,"publisher":"MDPI AG","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>Heparin-induced thrombocytopenia (HIT) is a prothrombotic state caused by the buildup of platelet factor 4 antibodies with decreased platelet count caused by heparin therapeutic or prophylactic therapy. It is important to detect this complication, especially in critically ill patients and cardiac patients. Detection of HIT can be demonstrated by positive antibodies in a HIT panel. Based on clinical and laboratory findings, heparin use should be discontinued with immediate transition to alternative anticoagulation therapies. Thromboembolic events can be an adverse effect of HIT and can cause local tissue necrosis, especially in the lower extremity. This case is a retrospective medical record review of a 52-year-old man who was initially admitted as an outpatient for coronary artery bypass grafting and mitral valve replacement who developed digital gangrene from HIT. This case emphasizes the rare adverse effects of HIT and the need for timely consultation for surgical treatment of limb ischemia\/gangrene.<\/jats:p>","DOI":"10.7547\/21-014","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T13:36:13Z","timestamp":1694525773000},"source":"Crossref","is-referenced-by-count":2,"title":["Bilateral Digital Ischemia Secondary to Heparin-Induced Thrombocytopenia with Subsequent Limb Salvage: A Case Study"],"prefix":"10.3390","volume":"113","author":[{"given":"Sara","family":"Mateen","sequence":"first","affiliation":[{"name":"Temple University Hospital, Philadelphia, PA. Dr. Mateen is now with Hackensack University Medical Center, Hackensack, NJ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Pontious","sequence":"additional","affiliation":[{"name":"Temple University Hospital, Philadelphia, PA. Dr. Mateen is now with Hackensack University Medical Center, Hackensack, NJ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buckmaster","sequence":"additional","affiliation":[{"name":"Columbus Regional Health, Columbus, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Hasenstein","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Oklahoma College of Medicine, School of Community Medicine, Tulsa, OK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"N Engl J Med","first-page":"1330","article-title":"Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin","volume":"332","author":"Warkentin TE","year":"1995","unstructured":"Warkentin TE, Levine MN, Hirsh J, : Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. 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Anesthesiology 128: 390, 2018."},{"key":"B11","series-title":"GeneReviews\u00ae [Internet]","article-title":"\u201cFactor V Leiden Thrombophilia,\u201d","author":"Kujovich JL","year":"1993-2017","unstructured":"Kujovich JL: \u201cFactor V Leiden Thrombophilia,\u201d in GeneReviews\u00ae [Internet], ed by RA Pagon, MP Adam, HH Ardinger, , University of Washington, Seattle, 1993-2017. Available at: https:\/\/www.ncbi.nlm.nih.gov\/sites\/books\/NBK1368\/. Published May 14, 1999. Updated March 9, 2010."},{"key":"B12","series-title":"Clin Appl Thromb Hemost","first-page":"546","article-title":"A rare and undesirable complication of heparin-induced thrombocytopenia: acute massive pulmonary embolism","volume":"17","author":"Gul EE","year":"2011","unstructured":"Gul EE, Abdulhalikov T, Aslan R, : A rare and undesirable complication of heparin-induced thrombocytopenia: acute massive pulmonary embolism. Clin Appl Thromb Hemost 17: 546, 2011."},{"key":"B13","series-title":"Cochrane Database Syst Rev","first-page":"CD007557","article-title":"Unfractionated heparin versus low molecular weight heparins for avoiding heparin-induced thrombocytopenia in postoperative patients","volume":"4","author":"Junqueira DR","year":"2017","unstructured":"Junqueira DR, Zorzela LM, Perini E: Unfractionated heparin versus low molecular weight heparins for avoiding heparin-induced thrombocytopenia in postoperative patients. Cochrane Database Syst Rev 4: CD007557, 2017."},{"key":"B14","series-title":"Clin Appl Thrombosis\/Hemostasis","first-page":"546","article-title":"A rare and undesirable complication of heparin-induced thrombocytopenia: acute massive pulmonary embolism","volume":"17","author":"Gul EE","year":"2011","unstructured":"Gul EE, Abdulhalikov T, Aslan R, : A rare and undesirable complication of heparin-induced thrombocytopenia: acute massive pulmonary embolism. Clin Appl Thrombosis\/Hemostasis 17: 546, 2011."},{"key":"B15","series-title":"Chest","first-page":"478","article-title":"IVIG for treatment of severe refractory heparin-induced thrombocytopenia","volume":"152","author":"Padmanabhan A","year":"2017","unstructured":"Padmanabhan A, Jones CG, Pechauer SM, : IVIG for treatment of severe refractory heparin-induced thrombocytopenia. Chest 152: 478, 2017."},{"key":"B16","series-title":"Expert Rev Hematol","first-page":"685","article-title":"High-dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review","volume":"12","author":"Warkentin TE","year":"2019","unstructured":"Warkentin TE: High-dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review. 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