ASH evidence-based guidelines: is the IgG-specific anti-PF4/heparin ELISA superior to the polyspecific ELISA in the laboratory diagnosis of HIT?
You are asked to consult on a 76-year-old man admitted to the hospital with pneumonia and thrombocytopenia. Ten days before the current admission, he had undergone surgery to repair a small bowel obstruction. A preoperative platelet count had been normal. Following surgery, he received subcutaneous unfractionated heparin thromboprophylaxis until his discharge on post-operative day 5. In your differential diagnosis for the patient's thrombocytopenia, you consider heparin-induced thrombocytopenia (HIT) and wish to order laboratory testing. In addition to a polyspecific anti-PF4/heparin ELISA for the diagnosis of HIT, your laboratory has recently begun to offer an IgG-specific ELISA. You wonder which of these assays performs better in the diagnosis of HIT.
Cuker
Adam
A
Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. adam.cuker@uphs.upenn.edu
Ortel
Thomas L
TL
D000368:Aged; D000918:Antibody Specificity; D000925:Anticoagulants / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D019317:Evidence-Based Medicine; D006493:Heparin / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007415:Intestinal Obstruction / Q000601:surgery; D008297:Male; D010978:Platelet Factor 4 / Q000276:immunology*; D011183:Postoperative Complications / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000276:immunology
D000925:Anticoagulants; D001323:Autoantibodies; D007074:Immunoglobulin G; D010978:Platelet Factor 4; D006493:Heparin