ArticleJournal of thrombosis and haemostasis : JTH2020
Combination of two complementary automated rapid assays for diagnosis of heparin-induced thrombocytopenia (HIT).
Article in Journal of thrombosis and haemostasis : JTH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- Performance evaluation of a reflexive algorithm for suspected heparin-induced thrombocytopenia.Research and practice in thrombosis and haemostasis · 2026Article
- Development of an integrated clinical-laboratory scoring system for accurate HIT diagnosis.Blood advances · 2026Article
- A combination of 2 rapid immunoassays significantly improves diagnostic sensitivity for heparin-induced thrombocytopenia.American journal of clinical pathology · 2026Observational
- Anti-PF4 disorders: Pathogenesis, diagnosis and treatment.British journal of haematology · 2025Review
- Article
- Visceral Arterial Thrombosis Linked to Long-Term Oral Contraceptives and Smoking: A Case Report.The American journal of case reports · 2025Article
- Accuracy of Diagnosing Heparin-Induced Thrombocytopenia.JAMA network open · 2024Article
- Autoimmune Heparin-Induced Thrombocytopenia.Journal of clinical medicine · 2023Review
- A machine-learning model for reducing misdiagnosis in heparin-induced thrombocytopenia: A prospective, multicenter, observational study.EClinicalMedicine · 2023Article
- High-frequency Contactless Sensor for the Detection of Heparin-Induced Thrombocytopenia Antibodies via Platelet Aggregation.International journal of molecular sciences · 2022Article
- Temporal presentations of heparin-induced thrombocytopenia following cardiac surgery: A single-center, retrospective cohort study.Journal of thrombosis and haemostasis : JTH · 2022Article
- Combinations of rapid immunoassays for a speedy diagnosis of heparin-induced thrombocytopenia.Journal of thrombosis and haemostasis : JTH · 2022Article
- Indeterminate serotonin release assays are associated with a high mortality rate.Research and practice in thrombosis and haemostasis · 2022Article
- Vaccine-induced immune thrombotic thrombocytopenia: Updates in pathobiology and diagnosis.Frontiers in cardiovascular medicine · 2022Review
- Platelet variability index: a measure of platelet count fluctuations in patients with immune thrombocytopenia.Blood advances · 2021Article
- COVID-19 patients often show high-titer non-platelet-activating anti-PF4/heparin IgG antibodies.Journal of thrombosis and haemostasis : JTH · 2021Article
- Heparin-Induced Thrombocytopenia: A Review of New Concepts in Pathogenesis, Diagnosis, and Management.Journal of clinical medicine · 2021Review
- Challenges in Detecting Clinically Relevant Heparin-Induced Thrombocytopenia Antibodies.Hamostaseologie · 2020Review
- Combination of two complementary automated rapid assays for diagnosis of heparin-induced thrombocytopenia (HIT).Journal of thrombosis and haemostasis : JTH · 2020Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHIT diagnosis typically uses complementary diagnostic assays (eg, a PF4-dependent enzyme-immunoassay [EIA] and a platelet activation assay such as the serotonin-release assay [SRA]).
objectivesTo determine whether the combination of two automated assays-a latex immunoturbidimetric assay (LIA) that evaluates competitive inhibition of a HIT-like monoclonal antibody and a chemiluminescence immunoassay (CLIA) for detecting anti-PF4/heparin IgG-optimizes diagnostic sensitivity while also yielding good specificity, particularly at high assay reactivities. PATIENTS/
methodsWe determined operating characteristics using combined LIA/CLIA results from a HIT observational trial (n = 430; derivation cohort) and 147 consecutive patients with HIT (n = 147; supplementary derivation cohort). We also evaluated 678 consecutive samples referred for HIT testing (replication cohort). LIA/CLIA reactivities were scored individually as "negative" (<1.00 U/mL, 0 points), "weak" (1.00-4.99 U/mL, 1 point), "moderate" (5.00-15.99 U/mL, 2 points) and "strong" (≥16.00 U/mL, 3 points), thus contributing up to 6 points (maximum) when LIA/CLIA results were combined. We also examined whether higher LIA/CLIA scores predicted presence of platelet-activating antibodies by conventional and modified (PF4- or PF4/heparin-enhanced) SRA.
resultsCombined LIA/CLIA testing yielded high diagnostic sensitivity (~99%) similar to EIA. Interpretation of LIA/CLIA results using the 6-point scale indicated progressively greater likelihood for the presence of platelet-activating antibodies with increasing scores (semi-quantitative reactivity). A LIA/CLIA score ≥ 4 points predicted the presence of platelet-activating antibodies by SRA or PF4-enhanced SRA with high probability (~98%).
conclusionCombined LIA/CLIA testing optimizes diagnostic sensitivity, with progressively greater probability of detecting platelet-activating antibodies with higher assay reactivity that reaches 98% when both automated assays yield moderate or strong results.
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