| Step |
Clinical and Lab. assessment |
Action plan |
| 1 |
suspicion of HIT |
thrombocytopenia (<150×109 /L, unexplained decrease of > 30%), timing of over 5 days, no other cause of thrombocytopenia or thrombosis |
| 2 |
ELISA (IgG, A, M) |
no likelihood of HIT due to a negative qualitative assay |
| 3 |
specific IgG-ELISA |
high specificity for platelet-activating antibodies |
| 4 |
14C serotonin release assay
(platelet aggregation test) |
confirmation of HIT as a gold standard test
(not preferable due to being less sensitive) |
| 5 |
reassessment of HIT if necessary |
recheck other causes of thrombocytopenia and thrombosis, assess with alternative therapy |
