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HIT..the classical and the non classical

Three subtypes of HIT:

 1. Typical or classical onset HIT. Typically, the platelet count falls gradually starting 5 to 10 days (up to 2 weeks) after the initiation of heparin.  Thrombocytopenic levels may not occur until several days later.
heparin HIT window
2. Early or rapid-onset HIT.  In some cases, thrombocytopenia may occur abruptly within 5 days of heparin therapy.  The rapid onset suggests exposure to heparin within the past 3 months and the presence of circulating HIT antibodies.  Since the antibodies are already present, thrombocytopenia may occur promptly with heparin administration.
prior heparin HIT window
3.     Delayed-onset HIT.  Although rare, thrombocytopenia may occur from several days to more than a month after cessation of heparin.  Such patients may have high titers of HIT antibody.
delayed onset HIT

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