<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">emcardio</journal-id><journal-title-group><journal-title xml:lang="ru">Неотложная кардиология и кардиоваскулярные риски</journal-title><trans-title-group xml:lang="en"><trans-title>Emergency Cardiology and Cardiovascular Risks journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2616-633X</issn><publisher><publisher-name>Белорусский государственный медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">emcardio-281</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Обзоры и лекции</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Reviews and lectures</subject></subj-group></article-categories><title-group><article-title>Гепарининдуцированная тромбоцитопения</article-title><trans-title-group xml:lang="en"><trans-title>Heparin-induced thrombocytopenia</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дударенко</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dudarenko</surname><given-names>S. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ежова</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ezhova</surname><given-names>O. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>ФГБУ ВЦЭРМ им. А.М.Никифорова МЧС России</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>14</day><month>11</month><year>2025</year></pub-date><volume>2</volume><issue>1</issue><fpage>252</fpage><lpage>257</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дударенко С.В., Ежова О.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Дударенко С.В., Ежова О.А.</copyright-holder><copyright-holder xml:lang="en">Dudarenko S.V., Ezhova O.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://emcardio.bsmu.by/jour/article/view/281">https://emcardio.bsmu.by/jour/article/view/281</self-uri><abstract><p>Широкое применение гепарина в медицине (кардиологии и кардиохирургии, травматологии, нейрохирургии, реаниматологии и др.) в последнее время породило и ряд проблем. Практический кардиолог, кардиореаниматолог и врачи других специальностей при использовании гепарина все чаще сталкиваются с проблемой гепарининдуцированной тромбоцитопении (ГИТ). Внедрение новых методов в реанимационную практику и применение ЭКМО-технологий, хронического гемодиализа, использование аппаратов искусственного кровообращения делает ГИТ особенно актуальной ввиду возможности развития крайне опасных и даже потенциально смертельных осложнений. ГИТ характеризуется особенной клинической картиной, ведущее значение в которой имеют не кровотечения, а множественные венозные и артериальные тромбозы. В клинической практике сложности возникают не только в диагностике, но и в выборе тактики ведения пациентов с выявленным синдромом ГИТ.</p></abstract><trans-abstract xml:lang="en"><p>A wide use of heparin in medicine (cardiology and cardiosurgery, traumatology, neurosurgery, intensive care medicine, etc.) has recently caused a number of problems. In the use of heparin cardiologists, intensive care specialists and other physicians increasingly face the problem of heparin-induced thrombocytopenia (HIT). The introduction of new methods into resuscitation practice and the use of ECMO-technologies, chronic hemodialysis, the use of artificial circulation apparatus makes HIT a problem of current importance due to the possibility of extremely dangerous and even potentially fatal complications. HIT is characterized by a specific disease pattern, the leading significance in which is not bleeding, but multiple venous and arterial thrombosis. In clinical practice, difficulties appear not only in the diagnosis, but also in the choice of tactics for managing patients with identified HIT syndrome.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>гепарининдуцированная тромбоцитопения</kwd><kwd>нефракционированный гепарин</kwd><kwd>низкомолекулярные гепарины</kwd><kwd>прямые ингибиторы тромбина</kwd><kwd>тромбоз</kwd></kwd-group><kwd-group xml:lang="en"><kwd>heparin-induced thrombocytopenia</kwd><kwd>unfractionated heparin</kwd><kwd>low-molecular heparins</kwd><kwd>direct thrombin inhibitors</kwd><kwd>thrombosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Morel-Kopp M.C., Aboud M., Tan C.W., Kulathilake C., Ward C. Heparin-induced thrombocytopenia: evaluation of IgG and IgGAM ELISA assays. Int J Lab Hematol, 2011, vol. 33, no. 3, pp. 245-250. doi:10.1111/j.1751-553X.2010.01276.x.</mixed-citation><mixed-citation xml:lang="en">Morel-Kopp M.C., Aboud M., Tan C.W., Kulathilake C., Ward C. Heparin-induced thrombocytopenia: evaluation of IgG and IgGAM ELISA assays. Int J Lab Hematol, 2011, vol. 33, no. 3, pp. 245-250. doi:10.1111/j.1751-553X.2010.01276.x.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E. Clinical picture of heparin-induced thrombocytopenia (HIT) and its differentiation from non-HIT thrombocytopenia. Thromb Haemost, 2016, vol. 116, no. 5, pp. 813-822.</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E. Clinical picture of heparin-induced thrombocytopenia (HIT) and its differentiation from non-HIT thrombocytopenia. Thromb Haemost, 2016, vol. 116, no. 5, pp. 813-822.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Rollin J., Pouplard C., Gruel Y. Risk factors for heparin-induced thrombocytopenia: Focus on Fcy receptors. Thromb Haemost, 2016, vol. 116, no. 5, pp. 799-805.</mixed-citation><mixed-citation xml:lang="en">Rollin J., Pouplard C., Gruel Y. Risk factors for heparin-induced thrombocytopenia: Focus on Fcy receptors. Thromb Haemost, 2016, vol. 116, no. 5, pp. 799-805.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E., Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg, 2003, vol. 76, no. 2, pp. 638-648.</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E., Greinacher A. Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg, 2003, vol. 76, no. 2, pp. 638-648.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Price E.A., Hayward C.P., Moffat K.A., Moore J.C., Warkentin T.E., Zehnder J.L. Laboratory testing for heparin-induced thrombocytopenia is inconsistent in North America: a survey of North American specialized coagulation laboratories. Thromb Haemost. 2007, vol. 98, no. 6, pp. 1357-1361.</mixed-citation><mixed-citation xml:lang="en">Price E.A., Hayward C.P., Moffat K.A., Moore J.C., Warkentin T.E., Zehnder J.L. Laboratory testing for heparin-induced thrombocytopenia is inconsistent in North America: a survey of North American specialized coagulation laboratories. Thromb Haemost. 2007, vol. 98, no. 6, pp. 1357-1361.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E., Heddle N.M. Laboratory diagnosis of immune heparin-induced thrombocytopenia. Cur Hematol Rep, 2003, vol. 2, no. 2, pp. 148-157.</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E., Heddle N.M. Laboratory diagnosis of immune heparin-induced thrombocytopenia. Cur Hematol Rep, 2003, vol. 2, no. 2, pp. 148-157.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E., Sheppard J.A., Moore J.C., Moore K.M., Isgouin C.S., Kelton J.G. Laboratory testing for the antibodies that cause heparin-induced thrombocytopenia: how much class do we need? J Lab Clin Med, 2005, vol. 146, no. 6, pp. 341-346.</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E., Sheppard J.A., Moore J.C., Moore K.M., Isgouin C.S., Kelton J.G. Laboratory testing for the antibodies that cause heparin-induced thrombocytopenia: how much class do we need? J Lab Clin Med, 2005, vol. 146, no. 6, pp. 341-346.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Grouzi E. Update on argatroban for the prophylaxis and treatment of heparin-induced thrombocytopenia type II. J Blood Med, 2014, vol. 5, pp.131-141.</mixed-citation><mixed-citation xml:lang="en">Grouzi E. Update on argatroban for the prophylaxis and treatment of heparin-induced thrombocytopenia type II. J Blood Med, 2014, vol. 5, pp.131-141.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Tardy-Poncet B., Nguyen P., Thiranos J.C., Morange P.E., Biron-Andréani C., Gruel Y., Morel J., Wynckel A., Grunebaum L., Villacorta-Torres J., Grosjean S., de Maistre E. Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial. Crit Care, 2015, vol. 19, pp. 396. doi: 10.1186/s13054-015-1109-0.</mixed-citation><mixed-citation xml:lang="en">Tardy-Poncet B., Nguyen P., Thiranos J.C., Morange P.E., Biron-Andréani C., Gruel Y., Morel J., Wynckel A., Grunebaum L., Villacorta-Torres J., Grosjean S., de Maistre E. Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial. Crit Care, 2015, vol. 19, pp. 396. doi: 10.1186/s13054-015-1109-0.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Cardenas G.A., Deitcher S.R. Risk of anaphylaxis after reexposure to intravenous lepirudin in patients with current or past heparin-induced thrombocytopenia. Mayo Clin Proc, 2005, vol. 80, no. 4, pp. 491-493.</mixed-citation><mixed-citation xml:lang="en">Cardenas G.A., Deitcher S.R. Risk of anaphylaxis after reexposure to intravenous lepirudin in patients with current or past heparin-induced thrombocytopenia. Mayo Clin Proc, 2005, vol. 80, no. 4, pp. 491-493.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Greinacher A., Lubenow N., Eichler P. Anaphylactic and anaphylactoid reactions associated with lepirudin in patients with heparin-induced thrombocytopenia. Circulation, 2003, vol. 108, no. 17, pp. 2062-2065.</mixed-citation><mixed-citation xml:lang="en">Greinacher A., Lubenow N., Eichler P. Anaphylactic and anaphylactoid reactions associated with lepirudin in patients with heparin-induced thrombocytopenia. Circulation, 2003, vol. 108, no. 17, pp. 2062-2065.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Petros S. Lepirudin in the management of patients with heparininduced thrombocytopenia. Biologics. 2008, vol. 2, no. 3, pp. 481-490.</mixed-citation><mixed-citation xml:lang="en">Petros S. Lepirudin in the management of patients with heparininduced thrombocytopenia. Biologics. 2008, vol. 2, no. 3, pp. 481-490.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Meddahi S., Samama M.M. Direct inhibitors of thrombin, hirudin, bivalirudin, and dabigatran etexilate. J Mal Vasc, 2011, vol. 36, no. 1, pp. 24-32.</mixed-citation><mixed-citation xml:lang="en">Meddahi S., Samama M.M. Direct inhibitors of thrombin, hirudin, bivalirudin, and dabigatran etexilate. J Mal Vasc, 2011, vol. 36, no. 1, pp. 24-32.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Sciulli T.M., Mauro V.F. Pharmacology and clinical use of bivalirudin. Ann Pharmacother. 2002, vol. 36, no. 6, pp. 1028-1041.</mixed-citation><mixed-citation xml:lang="en">Sciulli T.M., Mauro V.F. Pharmacology and clinical use of bivalirudin. Ann Pharmacother. 2002, vol. 36, no. 6, pp. 1028-1041.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Magnani H.N., Gallus A. Heparin-induced thrombocytopenia (HIT). A report of 1,478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid-2004. Thromb Haemost. 2006, vol. 95, no. 6, pp. 967-981.</mixed-citation><mixed-citation xml:lang="en">Magnani H.N., Gallus A. Heparin-induced thrombocytopenia (HIT). A report of 1,478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid-2004. Thromb Haemost. 2006, vol. 95, no. 6, pp. 967-981.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Tardy-Poncet B., Wolf M., Lasne D., Bauters A., Ffrench P., Elalamy I., Tardy B. Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases. Intensive Care Med, 2009, vol. 35, no. 8, pp. 1449-1453.</mixed-citation><mixed-citation xml:lang="en">Tardy-Poncet B., Wolf M., Lasne D., Bauters A., Ffrench P., Elalamy I., Tardy B. Danaparoid cross-reactivity with heparin-induced thrombocytopenia antibodies: report of 12 cases. Intensive Care Med, 2009, vol. 35, no. 8, pp. 1449-1453.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Bhatt V.R., Aryal M.R., Shrestha R., Armitage J.O. Fondaparinux- associated: heparin-induced thrombocytopenia. Eur J Haematol, 2013, vol. 91, no. 5, pp. 437-441. doi: 10.1111/ejh.12179. Epub 2013 Aug 20.</mixed-citation><mixed-citation xml:lang="en">Bhatt V.R., Aryal M.R., Shrestha R., Armitage J.O. Fondaparinux- associated: heparin-induced thrombocytopenia. Eur J Haematol, 2013, vol. 91, no. 5, pp. 437-441. doi: 10.1111/ejh.12179. Epub 2013 Aug 20.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Ozsu S., Korkmaz A., Bülbül Y., Oztuna F., Ozlü T. Fondaparinux treatment in heparin induced thrombocytopenia: a case report. Tuberk Toraks, 2011, vol. 59, no. 2, pp. 178-183.</mixed-citation><mixed-citation xml:lang="en">Ozsu S., Korkmaz A., Bülbül Y., Oztuna F., Ozlü T. Fondaparinux treatment in heparin induced thrombocytopenia: a case report. Tuberk Toraks, 2011, vol. 59, no. 2, pp. 178-183.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E., Maurer B.T., Aster R.H. Heparin-induced thrombocytopenia associated with fondaparinux. N. Engl J Med, 2007, vol. 356, no. 25, pp. 2653-2654.</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E., Maurer B.T., Aster R.H. Heparin-induced thrombocytopenia associated with fondaparinux. N. Engl J Med, 2007, vol. 356, no. 25, pp. 2653-2654.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Bircan H.A., Alanoglu E.G. Massive pulmonary embolism in a patient with heparin induced thrombocytopenia: successful treatment with dabigatran. Eurasian J Med, 2016, vol. 48, no. 1, pp. 65-68.</mixed-citation><mixed-citation xml:lang="en">Bircan H.A., Alanoglu E.G. Massive pulmonary embolism in a patient with heparin induced thrombocytopenia: successful treatment with dabigatran. Eurasian J Med, 2016, vol. 48, no. 1, pp. 65-68.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Larsen P.B., Jшrgensen M., Friis-Hansen L., Ingeberg S. Apixaban used for the management of heparin-induced thrombocytopenia in a 72-year-old woman with lung cancer. Clin Case Rep, 2015, vol. 3, no. 12, pp. 987-989.</mixed-citation><mixed-citation xml:lang="en">Larsen P.B., Jшrgensen M., Friis-Hansen L., Ingeberg S. Apixaban used for the management of heparin-induced thrombocytopenia in a 72-year-old woman with lung cancer. Clin Case Rep, 2015, vol. 3, no. 12, pp. 987-989.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Sartori M., Favaretto E., Cini M., Legnani C., Cosmi B. Rivaroxaban in the treatment of heparin-induced thrombocytopenia. J Thromb Thrombolysis, 2015, vol. 40, no. 3, pp. 392-394.</mixed-citation><mixed-citation xml:lang="en">Sartori M., Favaretto E., Cini M., Legnani C., Cosmi B. Rivaroxaban in the treatment of heparin-induced thrombocytopenia. J Thromb Thrombolysis, 2015, vol. 40, no. 3, pp. 392-394.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Warkentin T.E., Pai M., Linkins L.A. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review. Blood, 2017, vol. 130, no. 9, pp. 1104-1113</mixed-citation><mixed-citation xml:lang="en">Warkentin T.E., Pai M., Linkins L.A. Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review. Blood, 2017, vol. 130, no. 9, pp. 1104-1113</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
