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The multiple steps of HIT disorder. After immunization, there is initiation (upper left) culminating in IC-mediated platelet activation, then propagation (lower right) marked by the central roles of thrombin. Thrombin feeds back to enhance cellular activation and cleaves fibrinogen to fibrin. GAG, glycosaminoglycan; HIT, heparin-induced thrombocytopenia; IC, immune complex; PF4, platelet factor 4; ULC, ultralarge complex.
