Indiscriminately ordering blood tests for rare heparin reaction can lead to patient harm and increased costs

Testing for rare heparin reaction is unnecessary for most cases and can be potentially harmful and lead to increased costs, according to an article published in JAMA Internal Medicine.

Heparin is a common thinner used in hospitals to prevent and treat in the legs and lungs. Heparin can very rarely cause a reaction called 'heparin induced ' or HIT, leading to decrease in number of and . Physicians aware of this rare side effect can test for it to detect it early and prevent devastating complications. However, this reaction occurs in only 0.1 to 5% of patients, and the screening tests are notoriously unreliable. False positive results on these screening tests can cause unfavorable consequences for the patient.

Abhishek Maiti, MBBS, from the University of Texas Health Science Center at Houston, and colleagues describe a case of a patient who developed low platelet count from infection, however it was attributed to this rare heparin reaction. The testing for this heparin reaction came back falsely positive which led to a cascade of events which led to the patient having bleeding, and transfusion of blood products. Fortunately, the patient made a full recovery, and was discharged home a few days later.

The authors urge other physicians to be more thoughtful while considering this rare reaction to blood thinners and to be more cautious about ordering these tests. There are excellent scoring systems developed to check probability of this rare condition, and can help rule out majority of cases without having to resort to expensive testing. The authors conclude that "As physicians, we need to remember that indiscriminate testing for HIT, even though well-intentioned, can lead to unfavorable outcomes."

Explore further

Platelet transfusions increase odds of death in some rare blood cell disorders

More information: Abhishek Maiti et al, Indiscriminate Testing for Heparin-Induced Thrombocytopenia, JAMA Internal Medicine (2016). DOI: 10.1001/jamainternmed.2016.0363
Journal information: JAMA Internal Medicine

Citation: Indiscriminately ordering blood tests for rare heparin reaction can lead to patient harm and increased costs (2016, April 28) retrieved 19 January 2022 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Feedback to editors