Delayed-Onset Heparin-Induced Thrombocytopenia and Cerebral Thrombosis after a Single Administration of Unfractionated Heparin

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Abstract
Delayed-onset heparin-induced thrombocytopenia, a newly described syndrome of immune-mediated thrombocytopenia that begins several days after heparin therapy has been discontinued,1,2 is caused by IgG antibodies that are reactive against platelet factor 4–heparin complexes that activate platelets even in the absence of pharmacologic heparin.1 The minimal amount of heparin required to initiate this syndrome is unknown.