Pathogenic heparin-induced thrombocytopenia and thrombosis (HIT) antibodies determined by rapid functional flow cytometry
Cipok M., Tomer A., E`lalami M. I. Zh., Kirgner I., Dror N., Kay S., Deutsch V. R.
European Journal of Haematology
Vol.103, Issue3, P. 225-233
Опубликовано: 2019
Тип ресурса: Статья
Аннотация:
Objectives: Reliable diagnosis of heparin-induced thrombocytopenia and thrombosis (HIT) is mandatory for patient management, yet prompt determination of pathogenic antibodies remains an unmet clinical challenge. Common immunoassays carry inherent limitations and functional assays which detect antibody-mediated platelet activation are not usually readily available to routine laboratories, especially the serotonin release assay (SRA), being technically demanding, time consuming, and requires high level expertise. To overcome some of these limitations, we have developed a practical functional flow cytometric assay (FCA) for routine clinical use. Methods: A simple FCA is described which avoids platelet manipulation, is highly specific and sensitive compared with SRA, and provides rapid results. Results: Of the 650 consecutive samples, from HIT-suspected patients, 99 (15.3[%]) were positive by the PaGIA Heparin/PF4 immunoassay and 31 (4.8[%]) by FCA. Average platelet activation was 11-fold high
Ключевые слова:
antibodies; flow cytometry; heparin-induced; thrombocytopenia; thrombosis
heparin; heparin platelet factor 4 antibody; autoantibody; heparin; adult; aged; area under the curve; Article; clinical decision making; comparative study; controlled study; correlational study; female; flow cytometry; heparin induced thrombocytopenia; heparinization; human; immunoassay; laboratory test; major clinical study; male; platelet count; priority journal; sensitivity and specificity; serotonin release; thrombocyte activation; thrombocyte kinetics; thrombocyte rich plasma; thrombosis; blood; disease management; immunology; metabolism; middle aged; procedures; receiver operating characteristic; symptom assessment; thrombocyte; thrombocytopenia; thrombosis; very elderly; young adult; Adult; Aged; Aged, 80 and over; Autoantibodies; Blood Platelets; Disease Management; Female; Flow Cytometry; Heparin; Humans; Immunoassay; Male; Middle Aged; Platelet Activation; Platelet Count; ROC Curve; Symptom Assessment; Thrombocytopenia; Thrombosis; Young Adult
Язык текста: Английский
ISSN: 1600-0609
Cipok M.
Tomer A.
E`lalami M. I. Zh. Mule` Ismail Zhabran 1958-
Kirgner I.
Dror N.
Kay S.
Deutsch V. R.
Cипок М.
Томер А.
Элалами М. И. Ж. Мулэ Исмаил Жабран 1958-
Киргнер И.
Дрор Н.
Кай С.
Деуцч В. Р.
Pathogenic heparin-induced thrombocytopenia and thrombosis (HIT) antibodies determined by rapid functional flow cytometry
Текст визуальный непосредственный
European Journal of Haematology
Munksgaard International Publishers
Vol.103, Issue3 P. 225-233
2019
Статья
antibodies flow cytometry heparin-induced thrombocytopenia thrombosis
heparin heparin platelet factor 4 antibody autoantibody heparin adult aged area under the curve Article clinical decision making comparative study controlled study correlational study female flow cytometry heparin induced thrombocytopenia heparinization human immunoassay laboratory test major clinical study male platelet count priority journal sensitivity and specificity serotonin release thrombocyte activation thrombocyte kinetics thrombocyte rich plasma thrombosis blood disease management immunology metabolism middle aged procedures receiver operating characteristic symptom assessment thrombocyte thrombocytopenia thrombosis very elderly young adult Adult Aged Aged, 80 and over Autoantibodies Blood Platelets Disease Management Female Flow Cytometry Heparin Humans Immunoassay Male Middle Aged Platelet Activation Platelet Count ROC Curve Symptom Assessment Thrombocytopenia Thrombosis Young Adult
Objectives: Reliable diagnosis of heparin-induced thrombocytopenia and thrombosis (HIT) is mandatory for patient management, yet prompt determination of pathogenic antibodies remains an unmet clinical challenge. Common immunoassays carry inherent limitations and functional assays which detect antibody-mediated platelet activation are not usually readily available to routine laboratories, especially the serotonin release assay (SRA), being technically demanding, time consuming, and requires high level expertise. To overcome some of these limitations, we have developed a practical functional flow cytometric assay (FCA) for routine clinical use. Methods: A simple FCA is described which avoids platelet manipulation, is highly specific and sensitive compared with SRA, and provides rapid results. Results: Of the 650 consecutive samples, from HIT-suspected patients, 99 (15.3[%]) were positive by the PaGIA Heparin/PF4 immunoassay and 31 (4.8[%]) by FCA. Average platelet activation was 11-fold high