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Systematic review on heparin-induced thrombocytopenia in children: a call to action.
MedLine Citation:
PMID:  23350790     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Heparin-induced-thrombocytopenia (HIT) has increasingly been reported in children as an indication for use of new alternative anticoagulant drugs (NAADs). OBJECTIVES: To systematically review the literature regarding: a) the incidence and prevalence of seroconversion and HIT and b) the clinical/laboratory findings and management of HIT in children. DESIGN/METHODS: MEDLINE and EMBASE databases were searched for studies that reported pediatric cases of HIT. Methodological reliability assessment of studies was performed with the Loney scale. Results: The incidence of seroconversion in neonates ranged between 0-1.7%. There were no cases of neonatal HIT in the included cohorts. The incidence range of seroconversion in the non-neonatal population was 1.3-52%. The incidence of HIT in non-neonates after cardiopulmonary bypass was 0.33% (95%CI: <0.01-2.04). Whereas more than half of pediatric cases labeled as HIT (30/52) did not include pivotal features of this syndrome, 80% of them received NAADs. CONCLUSION: The incidence of HIT has likely been overestimated in children, leading to potential misuse of NAADs in many cases. Clinical findings and laboratory assessment of pediatric cases are poorly described in the literature at present. Thorough laboratory investigation, proper reporting of cases, and adequate design of studies are mandatory to elucidate the clinical/laboratory picture of pediatric HIT. © 2013 International Society on Thrombosis and Haemostasis.
Authors:
M L Avila; V Shah; L R Brandão
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 International Society on Thrombosis and Haemostasis.
Affiliation:
Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
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