Heparin-induced thrombocytopenia: towards standardization of platelet factor 4/heparin antigen tests

Journal of Thrombosis and Haemostasis : JTH
Andreas GreinacherTheodore E Warkentin

Abstract

Laboratory confirmation of heparin-induced thrombocytopenia (HIT) is based on detection of heparin-dependent platelet-activating antibodies. Platelet factor 4 (PF4)/heparin enzyme-immunoassays (EIA) are a widely available surrogate for platelet-activating antibodies. Defining the optical density (OD) reactivity profiles of a PF4/heparin EIA in reference subject and patient populations and the correlation of the EIA results (expressed in OD units) with the prevalence of platelet-activating antibodies. Using quantile regression we determined the 97.5th percentile of PF4/heparin-immunoglobulin G (IgG) EIA reactivities in non-heparin-treated individuals [blood donors (n = 935)] and patients before heparin therapy (n = 1207). In patients with suspected HIT, we compared the correlation of EIA-IgG reactivities (Greifswald laboratory; n = 2821) and the heparin-induced platelet activation assay (HIPA) with the correlation of reactivities of another EIA-IgG (McMaster laboratory; n = 1956) with the serotonin-release assay (SRA). PF4/heparin-IgG EIA OD reactivities had a lower OD 97.5th percentile in blood donors compared with patient groups before heparin treatment (P < 0.001). The percentage of sera testing positive in the functional ass...Continue Reading

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Citations

Mar 29, 2008·PLoS Computational Biology·Sichun Yang, Benoît Roux
Aug 10, 2010·Der Internist·T ThieleA Greinacher
Oct 14, 2010·Der Internist·V Kiefel, A Greinacher
Dec 14, 2011·Hematology·Theodore E Warkentin
Sep 6, 2012·Journal of Thrombosis and Haemostasis : JTH·T E WarkentinUNKNOWN scientific and standardization committee of the international society on thrombosis and haemostasis
Sep 3, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·R BachmannA Heininger
Apr 5, 2013·Journal of Thrombosis and Haemostasis : JTH·I NaziJ G Kelton
Aug 4, 2011·Journal of Thrombosis and Haemostasis : JTH·T E Warkentin
Apr 23, 2014·International Journal of Laboratory Hematology·T BakchoulA Greinacher
Aug 25, 2015·SpringerPlus·Marion WiegeleEva Schaden
Apr 6, 2012·Expert Opinion on Pharmacotherapy·Miriam E Jaax, Andreas Greinacher
Jul 16, 2015·The New England Journal of Medicine·Andreas Greinacher
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May 12, 2012·Blood·Bruce S SachaisDouglas B Cines
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