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Review
. 2003 Sep;10(5):731-40.
doi: 10.1128/cdli.10.5.731-740.2003.

Laboratory diagnosis of heparin-induced thrombocytopenia and monitoring of alternative anticoagulants

Albrecht Leo  1 , Susanne Winteroll
Affiliations
Review

Laboratory diagnosis of heparin-induced thrombocytopenia and monitoring of alternative anticoagulants

Albrecht Leo et al. Clin Diagn Lab Immunol. 2003 Sep.
No abstract available

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Figures

FIG. 1.
FIG. 1.
Current model for the pathophysiological mechanism of HIT II. Step 1, binding of i.v. applied heparin to PF4 results in the formation of a neoepitope. Step 2, induction of an immune response against the PF4/heparin complex with antibody formation. Step 3, the complex of PF4/heparin and specific antibody associates with platelets via binding of the antibody Fc part to the platelet immunoglobulin receptor FcγRIIa, representing the major step in platelet activation in HIT II. Step 4, activated platelets shed procoagulant microparticles which enhance thrombin generation. Step 5, association of PF4 with endothelial cell-bound heparan sulfate and subsequent antibody binding result in direct activation of endothelial cells, accelerating the procoagulant capacity. Step 6, activation of endothelial cells leads to expression of tissue factor, further increasing thrombin generation. Step 7, monocytes activated by PF4/heparin antibody binding tissue factor. (Reproduced from reference with permission of the publisher.)
See this image and copyright information in PMC

References

    1. Alving, B. M. 2003. How I treat heparin-induced thrombocytopenia and thrombosis. Blood 101:31-37. - PubMed
    1. Amiral, J., F. Bridey, M. Dreyfus, A. M. Vissoc, E. Fressinaud, M. Wolf, and D. Meyer. 1992. Platelet factor 4 complexed to heparin is the target for antibodies generated in heparin-induced thrombocytopenia. Thromb. Haemost. 68:95-96. - PubMed
    1. Amiral, J., F. Bridey, M. Wolf, C. Boyer-Neumann, E. Fressinaud, A. M. Vissac, E. Peynaud-Debayle, M. Dreyfus, and D. Meyer. 1995. Antibodies to macromolecular platelet factor 4-heparin complexes in heparin-induced thrombocytopenia: a study of 44 cases. Thromb. Haemost. 73:21-28. - PubMed
    1. Amiral, J., A. Marfaing-Koka, M. Wolf, M. C. Alessi, B. Tardy, C. Boyer-Neumann, A. M. Vissac, E. Fressinaud, M. Poncz, and D. Meyer. 1996. Presence of autoantibodies to interleukin-8 or neutrophil-activating peptide-2 in patients with heparin-associated thrombocytopenia. Blood 88:410-416. - PubMed
    1. Amiral, J., M. Wolf, A. Fischer, C. Boyer-Neumann, A. Vissac, and D. Meyer. 1996. Pathogenicity of IgA and/or IgM antibodies to heparin-PF4 complexes in patients with heparin-induced thrombocytopenia. Br. J. Haematol 92:954-959. - PubMed

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