Heparin-induced thrombocytopenia associated with interleukin-8-dependent platelet activation in a patient with antiphospholipid syndrome.
Platelet factor 4 heparin enzyme immunoassay, platelet aggregation test, and serotonin release assay are commonly used to diagnose and confirm heparin-induced thrombocytopenia. We describe a case of recurrent thrombocytopenia appearing in a few hours after each heparin administration and who tested negative for the three assays. Further analysis revealed anti-interleukin (IL)-8 antibodies and IL-8-dependent platelet activation facilitated by heparin, which may explain this unusual case of heparin-induced thrombocytopenia.
Bounameaux
Claire
C
Medical Department, Community Hospital of La Chaux-de-Fonds, La Chaux-de-Fonds, Switzerland. claire.bounameaux@ne.ch
Boehlen
Françoise
F
Membré
Aurélie
A
Genné
Daniel
D
Pouplard
Claire
C
Regnault
Véronique
V
de Moerloose
Philippe
P
D000925:Anticoagulants / Q000009:adverse effects; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007124:Immunoenzyme Techniques; D016209:Interleukin-8 / Q000097:blood*; D008875:Middle Aged; D015539:Platelet Activation; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood* / Q000139:chemically induced*
D000925:Anticoagulants; D016209:Interleukin-8; D006493:Heparin