Back to Search
Start Over
Evaluation of automated immunoassays in the diagnosis of heparin induced thrombocytopenia.
- Source :
-
Thrombosis research [Thromb Res] 2013 Mar; Vol. 131 (3), pp. e85-90. Date of Electronic Publication: 2013 Jan 23. - Publication Year :
- 2013
-
Abstract
- Background: Heparin-induced thrombocytopenia (HIT) is caused by platelet-activating antibodies that recognize platelet factor 4/heparin (PF4/hep) complexes. The in vitro demonstration of PF4/hep antibodies using functional and immunological methods is essential for optimal management of patients suspected to have HIT. Since functional assays are technically challenging and limited to specialized laboratories, antigen-binding assays are commonly used in routine laboratories.<br />Study Design: Blood samples from 448 consecutive patients in whom HIT was suspected were investigated using a latex agglutination test HemosIL® HIT-Ab(PF4-H) (HemosIL-Ab), two chemiluminescence tests HemosIL AcuStar HIT-Ab(PF4-H) (HemosIL AcuStar-Ab) and AcuStar HIT-IgG(PF4-H) (HemosIL AcuStar-IgG), an in-house PF4/hep IgG enzyme immunoassay (EIA) and the heparin induced platelet aggregation (HIPA) test.<br />Results: Antibodies against PF4/hep were detectable in 44 out of 119 samples using HemosIL-Ab among which 20 samples were also reactive in the HIPA; and in 122, 64 and 108 out of 448 sera using HemosIL AcuStar-Ab, HemosIL AcuStar-IgG and in-house PF4/hep IgG-EIA, respectively, among which 52 sera were also reactive in the HIPA. All assays had high sensitivities of >95% for platelet activating antibodies; however, they differed in their specificities. The highest specificity and positive predictive value was observed by HemosIL AcuStar-IgG (96% and 78%, respectively).<br />Conclusion: Automated immunoassays are useful in the laboratory investigations of HIT and present a potential improvement toward standardization of laboratory investigations of HIT. The high positive predictive capability may justify treating the patient with alternative anticoagulants without waiting for the results of a functional assay.<br /> (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Subjects :
- Agglutination
Automation
Heparin chemistry
Humans
Immunoenzyme Techniques
Immunoglobulin G chemistry
Latex chemistry
Luminescence
Platelet Aggregation
Predictive Value of Tests
Reproducibility of Results
Sensitivity and Specificity
Thrombocytopenia chemically induced
Heparin adverse effects
Immunoassay methods
Thrombocytopenia diagnosis
Thrombocytopenia immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-2472
- Volume :
- 131
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Thrombosis research
- Publication Type :
- Academic Journal
- Accession number :
- 23351665
- Full Text :
- https://doi.org/10.1016/j.thromres.2013.01.005