A Case of Heparin Induced Thrombocytopenia with Circulating Anti-PF4/Heparin Antibody

Abstract

Heparin-induced thrombocytopenia (HIT) is usually caused by anti-platelet factor 4 (PF4)/heparin antibodies, leading to intravascular platelet activation. Circulating anti-PF4/heaprin antibody (IgG, IgA and IgM) was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France) in a 61-yearold man with coronary artery disease and dyspnea on exercise. He had undergone a coronoary angiography using 2,000 unit of heparin before a procedure. On admission, laboratory testing revealed a platelet count of 296×10 9 /L and aPTT (activated partial thromboplastin time) of 38.1 sec. The fall in the platelet count was progressive, resulting in 42% and 53% of platelet counts on the 6th and 12th days after intravenous heparin administration, respectively. He was discharged after coronary artery bypass graft. On discharge, platelet count was normalized to be 212×10 9 /L. On the 7th day after dischage, anti-PF4/heaprin antibody was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France).

Usefulness of anti-PF4/heparin antibody test for intensive care unit patients with thrombocytopenia

“…As previously mentioned, to date, no studies, other than case reports, regarding seropositivity of PF4/heparin antibody using immunoassay have been published. [ 17 , 18 ]. Our study analyzed seropositivity of PF4/heparin antibody in 127 ICU patients who were receiving heparin by 2 kinds of immunoassays.…”