ReviewInternational journal of laboratory hematology2026
Classification of Platelet-Activating Anti-Platelet Factor 4 Disorders.
Review in International journal of laboratory hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Fulminant Thromboinflammatory Syndrome Following an Influenza-like Illness in an Adolescent: Clinical Insights from a Case Report.International journal of molecular sciences · 2026Article
- Classification of Platelet-Activating Anti-Platelet Factor 4 Disorders.International journal of laboratory hematology · 2026Review
- The hidden threat: understanding anti-PF4 disorders without proximate heparin exposure.Frontiers in immunology · 2026Review
- Diagnostic Reassessment of a Historical Case of Atypical Heparin-Induced Thrombocytopenia: Between Spontaneous Heparin-Induced Thrombocytopenia and a Vaccine-Induced Immune Thrombotic Thrombocytopenia-Like Syndrome.Life (Basel, Switzerland) · 2025Article
- M protein and the evolving spectrum of platelet-activating anti-PF4 disorders and MGTS and their linkage.Blood vessels, thrombosis & hemostasis · 2025Article
- Review
Corrections and comments
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Authors and funding
1 author.
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Abstract
introductionThe prototypic anti-platelet factor 4 (PF4) disorder-heparin-induced thrombocytopenia and thrombosis (HITT)-features immunoglobulin G (IgG) class antibodies that activate platelets, monocytes, and neutrophils in a mainly heparin-dependent fashion via Fcγ receptor-dependent cellular activation. The identification in 2021 of an ultrarare HITT-mimicking disorder, vaccine-induced immune thrombocytopenia and thrombosis (VITT)-triggered by two different adenoviral vector vaccines-abruptly broadened the spectrum of recognized anti-PF4 disorders.
objectiveTo classify platelet-activating anti-PF4 disorders, both HITT/HITT-like and VITT/VITT-like.
methodsLiterature was reviewed from the perspective of a researcher-clinician involved in identifying novel anti-PF4 disorders.
resultsAtypical presentations of HITT with proximate heparin triggers but which evince heparin-independent platelet-activating properties ("autoimmune HITT") have been recognized since 2001; heparin-independent platelet-activating properties also characterize HITT-mimicking disorders with undefined non-heparin triggers (e.g., post-knee replacement "spontaneous HITT"). Antibodies identical to those of (vaccine-induced) VITT can rarely be triggered by natural adenovirus infection. HITT and VITT antibodies recognize different epitopes on PF4. All the aforementioned anti-PF4 disorders are acute, transient, and self-limited. Recently, however, chronic anti-PF4 disorders featuring potent VITT-like properties of monoclonal proteins (M-proteins) have been identified: this oftentimes treatment-refractory entity, named "VITT-like monoclonal gammopathy of thrombotic significance" (VITT-like MGTS), dramatically expands the clinical spectrum of recognized anti-PF4 disorders. Anti-PF4 disorders with heparin-independent platelet-activating antibodies, whether HITT or VITT, may require management strategies beyond anticoagulation alone, including high-dose intravenous immunoglobulin (IVIG) or (for VITT-like MGTS) the Bruton's tyrosine kinase inhibitor, ibrutinib.
conclusionClinicians and laboratorians require knowledge of the rapidly broadening spectrum of recognized acute and chronic anti-PF4 disorders.
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