Even if we appreciate Dr. Fisher’s remarks, we still do not feel that our approach has been inadequate. Our opinion is based on some evidence, although we could not perform any laboratory investigation to better define the type of heparin-associated thrombocytopenia (HAT) . First, as is clearly demonstrated in figure 1 of our paper, the platelet count started to decrease on the day following the administration of heparin . In our patient, we could exclude any previous exposure to heparin, which, according to the current literature, represents a prerequisite for the occurrence of HAT II immediately following the initiation of heparin therapy. In the absence of such an exposure, HAT II is reported to occur after some days of heparin treatment .