Heparin-induced thrombocytopenia: a challenging diagnosis in haemodialysis. State of art and review of the literature.

Abstract Heparin-induced thrombocytopenia (HIT) is a life-threatening disorder caused by the exposure to heparin and characterized by high morbidity and mortality. It is largely underestimated because of its heterogeneous presentation ranging from a fall in platelet count antibodies positivity to serious thrombotic complications. Haemodialysis (HD) patients represent a high-risk population due to the anticoagulation use during extracorporeal treatments. It usually occurs in the first weeks from the start of HD, although it was reported in chronic HD patients after surgery procedures. When the diagnosis of HIT is formulated, heparin must be promptly stopped and an alternative anticoagulant has to be started. The aim of this review is to provide a comprehensive overview on the pathogenesis, diagnosis, and treatment of the HIT in HD in order to increase the awareness of physicians on this important clinical syndrome to promptly start the specific treatment.