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...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-10-01
|
| Series: | TH Open |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1653-5065 |
| _version_ | 1811341695785107456 |
|---|---|
| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-13T18:57:48Z |
| format | Article |
| id | doaj.art-ff25504293a14558bfca2e13846fd5e7 |
| institution | Directory Open Access Journal |
| issn | 2512-9465 |
| language | English |
| last_indexed | 2024-04-13T18:57:48Z |
| publishDate | 2021-10-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | TH Open |
| spelling | doaj.art-ff25504293a14558bfca2e13846fd5e72022-12-22T02:34:11ZengGeorg Thieme Verlag KGTH Open2512-94652021-10-010504e507e51210.1055/a-1653-5065Heparin-induced Thrombocytopenia Diagnosis: A Retrospective Study Comparing Heparin-induced Platelet Activation Test to 14C-serotonin Release AssayMarie-Caroline Gonthier0Nicolas Gendron1Philippine Eloy2Marie-Charlotte Bourrienne3Martine Alhenc-Gelas4Claire Pouplard5Bernard Tardy6Jean Szymezak7Charles Burdet8Vasiliki Gkalea9Dorothée Faille10Nadine Ajzenberg11Laboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceDépartement d'Epidémiologie, Biostatistique et Recherche Clinique, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceHematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), Paris, FranceCHRU Tours, Service d'hématologie-hémostase, Université de Tours, Tours, FranceInserm CIC 1408 CHU Saint Etienne, Saint-Etienne, FranceLaboratoire d'hématologie, CHU Robert Debré, Reims, FranceDépartement d'Epidémiologie, Biostatistique et Recherche Clinique, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory of Vascular Translational Science, Université de Paris, INSERM, et Laboratoire d'Hématologie, AH-HP, Bichat–Claude Bernard Hospital, Paris, FranceLaboratory 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.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1653-5065heparin-induced thrombocytopeniaheparin induced platelet activation test 14c-serotonin release assaypf4/heparin antibodieslaboratory diagnosis |
| spellingShingle | 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 TH Open heparin-induced thrombocytopenia heparin induced platelet activation test 14c-serotonin release assay pf4/heparin antibodies laboratory diagnosis |
| title | 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_short | 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 |
| topic | heparin-induced thrombocytopenia heparin induced platelet activation test 14c-serotonin release assay pf4/heparin antibodies laboratory diagnosis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1653-5065 |
| work_keys_str_mv | AT mariecarolinegonthier heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT nicolasgendron heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT philippineeloy heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT mariecharlottebourrienne heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT martinealhencgelas heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT clairepouplard heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT bernardtardy heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT jeanszymezak heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT charlesburdet heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT vasilikigkalea heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT dorotheefaille heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay AT nadineajzenberg heparininducedthrombocytopeniadiagnosisaretrospectivestudycomparingheparininducedplateletactivationtestto14cserotoninreleaseassay |