Two Cases of Heparin-Induced Thrombocytopenia Diagnosed by Particle Gel Immunoassay

Song, Kyu Sub; Chang, Soon Hee; Suh, Jang Soo

doi:10.3343/kjlm.2006.26.5.334

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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BackgroundIt is critical to differentiate heparin-induced thrombocytopenia (HIT) from disseminated intravascular coagulation (DIC) in heparinized intensive care unit (ICU) patients with thrombocytopenia because the therapeutic approach differs based on the cause. We investigated the usefulness of PF4/heparin antibody tests in these patients.MethodsA total of 127 heparinized ICU patients whose platelet counts were <150×109/L or reduced by >50% after 5-10 days of heparin therapy were enrolled. PF4/heparin antibodies were measured using 2 immunoassays. We assessed the probability of HIT by using Warkentin's 4T's scoring system for antibody positive patients and compared routinely performed coagulation test results between patients with and without antibodies to evaluate the ability of these tests to discriminate between HIT and DIC.ResultsPositive results were obtained for 14 (11.0%) and 11 (8.7%) patients in the 2 assays. The analysis performed using the 4T's scoring system revealed that 11 of 20 (15.7%) patients with antibodies in at least 1 assay had intermediate or greater probability of HIT. Patients without antibodies had significantly higher levels of D-dimer than those with antibodies. However, there were no intergroup differences in platelet counts, PT, aPTT, fibrinogen, DIC score, and rate of overt DIC.ConclusionSeropositivity for PF4/heparin antibody was 8.7-11.0% in the patients with thrombocytopenia, and more than a half of them had an increased probability of HIT. Among the routine coagulation tests, only D-dimer was informative for differentiating HIT from DIC. PF4/heparin antibody test is useful to ensure appropriate treatment for thrombocytopenic heparinized ICU patients.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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

et al. 2007

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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).

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Two Cases of Heparin-Induced Thrombocytopenia Diagnosed by Particle Gel Immunoassay

Cited by 2 publications

References 18 publications

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

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

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

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