Evidence map›Paper›PMID 24102149›Full record

ArticleUpsala journal of medical sciences2013

Alternative diagnosis to heparin-induced thrombocytopenia in two critically ill patients despite a positive PF4/heparin-antibody test.

Gregor Hron, Folke Knutson, Thomas Thiele, Karina Althaus, Christoph Busemann, Sigrun Friesecke, Andreas Greinacher, Norbert Lubenow

Open access · diamondAbstract readCase Reports
In one paragraph

Article in Upsala journal of medical sciences, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Gregor HronAbteilung für Transfusionsmedizin, Institut für Immunologie und Transfusionsemedizin, Ernst-Moritz-Arndt University Greifswald , Germany.
Folke Knutson
Thomas Thiele
Karina Althaus
Christoph Busemann
Sigrun Friesecke
Andreas Greinacher
Norbert Lubenow
Universität Greifswald · DEUniversitätsmedizin Greifswald · DEUppsala University Hospital · SEInstitute for Transfusion Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Thrombocytopenia can cause diagnostic challenges in patients who have received heparin. Heparin-induced thrombocytopenia (HIT) is often considered in the differential diagnosis, and a positive screening can be mistaken as confirmation of the disorder. We present two patients who both received low-molecular-weight heparin for several days. In the first patient, clinical judgment rejected the suspicion of HIT despite a positive screening assay, and treatment for the alternative diagnosis of post-transfusion purpura was correctly initiated. In the second patient, the inaccurate diagnosis HIT was pursued due to a positive screening assay, while the alternative diagnosis of drug-dependent thrombocytopenia caused by piperacillin/tazobactam was rejected. This resulted in re-exposure to piperacillin/tazobactam which caused a second episode of severe thrombocytopenia. A positive screening assay for platelet factor 4/heparin-antibody should be verified by a functional assay, especially in patients with low pretest probability for HIT.

Indexed as

AgedCritical IllnessDiagnosis, DifferentialEnzyme-Linked Immunosorbent AssayFemoral Neck FracturesHeparinHumansMethotrexatePancytopeniaPenicillanic AcidPiperacillinPlatelet CountPlatelet Factor 4Purpura, ThrombocytopenicTazobactamThrombocytopeniaHeparinMethotrexatePenicillanic AcidPiperacillinPlatelet Factor 4Tazobactam

Identifiers

PMID24102149
PMCPMC4190887
OpenAlexW2067202273

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.