What is the recommended management in a patient diagnosed with HIT I?

• A. Start direct thrombin inhibitors
• B. Continue heparin for a few more days
• C. Discontinue heparin only
• D. Administer protamine sulfate immediately

Answer: (C)

In the case of Heparin-Induced Thrombocytopenia type I (HIT I), the recommended management involves discontinuing heparin. HIT I is characterized by a mild, non-immune mediated drop in platelet count that typically resolves without significant complications. Unlike HIT II, which is associated with a risk of thrombosis and requires more intensive management, HIT I does not typically warrant the use of alternative anticoagulants or specific treatments.

Discontinuation of heparin is essential to prevent potential further complications or the unnecessary use of alternative therapies when the platelet count returns to normal in most cases. The patient can often be transitioned to another form of anticoagulation if necessary, but simply stopping heparin is sufficient to manage the mild and often self-limiting condition associated with HIT I.