Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug 17:11:267-277.
doi: 10.2147/JBM.S232648. eCollection 2020.

Current Perspectives on Diagnostic Assays and Anti-PF4 Antibodies for the Diagnosis of Heparin-Induced Thrombocytopenia

Kamal K Sahu  1 , Vishal Jindal  2 , Joseph Anderson  2 , Ahmad D Siddiqui  1 , Ishmael A Jaiyesimi  2
Affiliations
Review

Current Perspectives on Diagnostic Assays and Anti-PF4 Antibodies for the Diagnosis of Heparin-Induced Thrombocytopenia

Kamal K Sahu et al. J Blood Med. .

Abstract

Heparin-induced thrombocytopenia (HIT) is a recognized clinical entity in patients receiving unfractionated heparin and low-molecular weight heparin. Currently, diagnosing HIT includes the combination of a physician's clinical suspicion based on a clinical scoring system and a series of laboratory tests. In the present article, we discuss challenges in suspecting and diagnosing HIT in consideration of the turnaround time of available tests and recent advances in techniques and methodologies of newer immunoassays and functional assays.

Keywords: HIPA test; functional assay; heparin-induced thrombocytopenia; immunoassay; laboratory diagnosis; platelet factor 4; platelets; serotonin-release assay.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Guide to decision-making for HIT from suspicion to diagnosis, with advantages and disadvantages of the assays.
Figure 2
Figure 2
The five phases of HIT, ranging from cases of suspected HIT without confirmatory laboratory tests; acute HIT, a highly prothrombotic phase that persists until platelet-count recovery through subacute and remote HIT, where functional and immunologic assays return to negative.
Figure 3
Figure 3
Timeline from discovery of platelets, HIT, and subsequent diagnostic milestones.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jindal V, Singh A, Siddiqui AD, Leb L. The appropriateness of testing platelet factor 4/heparin antibody in patients suspected of heparin-induced thrombocytopenia. Cureus. 2018;10(10):e3532. doi:10.7759/cureus.3532 - DOI - PMC - PubMed
    1. Martel N, Lee J, Wells PS. Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis: a meta-analysis. Blood. 2005;106(8):2710–2715. doi:10.1182/blood-2005-04-1546 - DOI - PubMed
    1. Girolami B, Prandoni P, Stefani PM, et al. The incidence of heparin-induced thrombocytopenia in hospitalized medical patients treated with subcutaneous unfractionated heparin: a prospective cohort study. Blood. 2003;101(8):2955–2959. doi:10.1182/blood-2002-07-2201 - DOI - PubMed
    1. Warkentin TE, Sheppard J-AI, Sigouin CS, Kohlmann T, Eichler P, Greinacher A. Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia. Blood. 2006;108(9):2937–2941. doi:10.1182/blood-2005-11-012450 - DOI - PubMed
    1. Yanamandra U, Sahu KK, Malhotra P, Varma S. Thrombocytopaenia with absent radius (not radii). BMJ Case Rep. 2014;2014(jun02 1):bcr2014204844–bcr2014204844. doi:10.1136/bcr-2014-204844 - DOI - PMC - PubMed