Hematology- Q3 - bumbaonline

[ArchivalUser]

A 23 yr old guy presented with severe shortness of breath 3 days after long bone fracture. He was immediately started on heparin transfusion and symptoms started improving. 4th day after heparin transfusion his labs showed
Hb= 13gm/dl
WBC= 13000
Platelets= 50000
Immediately his heparin transfusion was stopped. Following which his lab values improved a little.
What is the most likely mechanism causing the thrombocytopenia?
a.Platelet destruction in spleen due to hyperactivity
b.Immune destruction of platelets by autoantibodies
c.Consumptive coagulopathy with destruction of platelets
d.Heparin induced idiosyncratic reaction
e.Generalised immune activity leading to thisphenomenon.

Please explain as u ans.

[ArchivalUser]

B...heparin induced thrombocytopenia...

[ArchivalUser]

This is Heparin induced thrombocytopenia. Type 1 occurs in the first 2 days as is not very severe,usually recovers after stopping heparin:
type 1 heparin-induced thrombocytopenia (HIT) is a nonimmune disorder, and it occurs with the direct effect of heparin on platelet activation.

Type 2 is more severe and can lead to thrombotic manifestations like DVT,stroke,MI, if not recognized and treated immediiately.
Type 2 heparin-induced thrombocytopenia (HIT) is an immune-mediated disorder which typically occurs 4-10 days after exposure to heparin, and it is the serious type with its life- and limb-threatening prothrombotic complications.

So, I will go with bb too( little unsure!), since platelet count decrease below 50% while on heparin therapy generally means HIT .

[ArchivalUser]

HIT..b is ans