Case Report

A Case of Hyperacute Severe Thrombocytopenia Occurring Less than 24 Hours after Intravenous Tirofiban Infusion

Table 2

The 4Ts score is the sum of the values for each of the 4 categories.

The 4Ts scoring system
4Ts category2 points1 point0 points

ThrombocytopeniaPlatelet count fall >50% and platelet nadir ≥20Platelet count 30%–50% or platelet nadir 10–19Platelet count fall <30% or platelet nadir <10
Timing of platelet count fallClear onset days 5–10 or platelet fall ≤1 day (prior heparin exposure within 30 days)Consistent with days 5–10 fall, but not clear (e.g., missing platelet counts); onset after day 10; or fall ≤1 day (prior heparin exposure 30–100 days ago)Platelet count ≤4 days without recent exposure
Thrombosis or other sequelaeNew thrombosis (confirmed); skin necrosis; acute systemic reaction postintravenous unfractionated heparin bolusProgressive or recurrent thrombosis; nonnecrotizing (erythematous) skin lesions; suspected thrombosis (not proven)None
Other causes of thrombocytopeniaNone apparentPossibleDefinite

Scores of 1–3, 4-5, and 6–8 are considered to correspond to a low (<5%), intermediate (∼14%), and high (∼64%) probability of HIT, respectively.