Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay

Laboratory confirmation of heparin-induced thrombocytopenia (HIT) is of crucial importance and remains challenging and relies on platelet functional assays highlighting the presence of heparin-dependent platelet-activating antibodies in patient serum or plasma. Platelet functional assays using washe...

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Autores principales:	Marie-Caroline Gonthier, Nicolas Gendron, Philippine Eloy, Marie-Charlotte Bourrienne, Martine Alhenc-Gelas, Claire Pouplard, Bernard Tardy, Jean Szymezak, Charles Burdet, Vasiliki Gkalea, Dorothée Faille, Nadine Ajzenberg
Formato:	article
Lenguaje:	EN
Publicado:	Georg Thieme Verlag KG 2021
Materias:	heparin-induced thrombocytopenia heparin induced platelet activation test 14c-serotonin release assay pf4/heparin antibodies laboratory diagnosis Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ff25504293a14558bfca2e13846fd5e7
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spelling	oai:doaj.org-article:ff25504293a14558bfca2e13846fd5e72021-11-09T23:57:37ZHeparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay2512-946510.1055/a-1653-5065https://doaj.org/article/ff25504293a14558bfca2e13846fd5e72021-09-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/a-1653-5065https://doaj.org/toc/2512-9465Laboratory confirmation of heparin-induced thrombocytopenia (HIT) is of crucial importance and remains challenging and relies on platelet functional assays highlighting the presence of heparin-dependent platelet-activating antibodies in patient serum or plasma. Platelet functional assays using washed platelets include the 14C-serotonin release assay (SRA), usually described as the gold standard, and the heparin-induced platelet activation assay (HIPA). Since its first comparison with SRA there has been no additional published study regarding HIPA diagnostic performances compared with SRA. Aim of our retrospective study was to compare the concordance between HIPA and SRA in HIT suspected-patients with positive anti-PF4/heparin antibodies between October 2010 and October 2015. Fifty-five HIT-suspected patients who beneficiated from both HIPA and SRA were included. Positive and negative percent agreements were 83.8% (95% CI 68.0–93.8%) and 66.7% (95% CI 41.0–86.7%), respectively. Overall percent agreement was 78.2% (95% CI 65.0–92.2%). Agreement was higher in patients who underwent cardiopulmonary bypass with extracorporeal circulation circuit for cardiac surgery. We also confirm that the use of a minimum of 2 platelet donors to establish positive HIT diagnosis and 4 platelet donors to exclude HIT diagnosis allows obtaining a good agreement with SRA. Although HIPA and SRA were performed with different platelet donors and in different laboratories, HIPA had a good positive agreement with SRA for HIT diagnosis, showing that HIPA is a useful functional assay that does not require radioactivity and could be developed worldwide to improve HIT diagnosis.Marie-Caroline GonthierNicolas GendronPhilippine EloyMarie-Charlotte BourrienneMartine Alhenc-GelasClaire PouplardBernard TardyJean SzymezakCharles BurdetVasiliki GkaleaDorothée FailleNadine AjzenbergGeorg Thieme Verlag KGarticleheparin-induced thrombocytopeniaheparin induced platelet activation test 14c-serotonin release assaypf4/heparin antibodieslaboratory diagnosisDiseases of the circulatory (Cardiovascular) systemRC666-701ENTH Open, Vol 05, Iss 04, Pp e507-e512 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	heparin-induced thrombocytopenia heparin induced platelet activation test 14c-serotonin release assay pf4/heparin antibodies laboratory diagnosis Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	heparin-induced thrombocytopenia heparin induced platelet activation test 14c-serotonin release assay pf4/heparin antibodies laboratory diagnosis Diseases of the circulatory (Cardiovascular) system RC666-701 Marie-Caroline Gonthier Nicolas Gendron Philippine Eloy Marie-Charlotte Bourrienne Martine Alhenc-Gelas Claire Pouplard Bernard Tardy Jean Szymezak Charles Burdet Vasiliki Gkalea Dorothée Faille Nadine Ajzenberg Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
description	Laboratory confirmation of heparin-induced thrombocytopenia (HIT) is of crucial importance and remains challenging and relies on platelet functional assays highlighting the presence of heparin-dependent platelet-activating antibodies in patient serum or plasma. Platelet functional assays using washed platelets include the 14C-serotonin release assay (SRA), usually described as the gold standard, and the heparin-induced platelet activation assay (HIPA). Since its first comparison with SRA there has been no additional published study regarding HIPA diagnostic performances compared with SRA. Aim of our retrospective study was to compare the concordance between HIPA and SRA in HIT suspected-patients with positive anti-PF4/heparin antibodies between October 2010 and October 2015. Fifty-five HIT-suspected patients who beneficiated from both HIPA and SRA were included. Positive and negative percent agreements were 83.8% (95% CI 68.0–93.8%) and 66.7% (95% CI 41.0–86.7%), respectively. Overall percent agreement was 78.2% (95% CI 65.0–92.2%). Agreement was higher in patients who underwent cardiopulmonary bypass with extracorporeal circulation circuit for cardiac surgery. We also confirm that the use of a minimum of 2 platelet donors to establish positive HIT diagnosis and 4 platelet donors to exclude HIT diagnosis allows obtaining a good agreement with SRA. Although HIPA and SRA were performed with different platelet donors and in different laboratories, HIPA had a good positive agreement with SRA for HIT diagnosis, showing that HIPA is a useful functional assay that does not require radioactivity and could be developed worldwide to improve HIT diagnosis.
format	article
author	Marie-Caroline Gonthier Nicolas Gendron Philippine Eloy Marie-Charlotte Bourrienne Martine Alhenc-Gelas Claire Pouplard Bernard Tardy Jean Szymezak Charles Burdet Vasiliki Gkalea Dorothée Faille Nadine Ajzenberg
author_facet	Marie-Caroline Gonthier Nicolas Gendron Philippine Eloy Marie-Charlotte Bourrienne Martine Alhenc-Gelas Claire Pouplard Bernard Tardy Jean Szymezak Charles Burdet Vasiliki Gkalea Dorothée Faille Nadine Ajzenberg
author_sort	Marie-Caroline Gonthier
title	Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
title_short	Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
title_full	Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
title_fullStr	Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
title_full_unstemmed	Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay
title_sort	heparin-induced thrombocytopenia diagnosis: a retrospective study comparing heparin-induced platelet activation test to 14c-serotonin release assay
publisher	Georg Thieme Verlag KG
publishDate	2021
url	https://doaj.org/article/ff25504293a14558bfca2e13846fd5e7
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Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release Assay

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