title: Presence of antiheparin/platelet factor 4 immunoglobulin g is associated with poor prognosis in patients with suspected disseminated intravascular coagulation.
abstract: The underlying inflammatory or infectious condition in disseminated intravascular coagulation (DIC) may stimulate the formation of antiheparin/platelet factor 4 (PF4) antibody, and the resulting antibody may affect the clinical course of DIC. We investigated the prognosis of antiheparin/PF4 antibodies in patients with suspected DIC. We measured heparin/PF4 immunoglobulin G (IgG) and total antibody levels using an automated chemiluminescence system in 118 patients with DIC. Of the 118 patients, 13 (11.0%) patients were positive for total antiheparin/PF4, and 6 (5.1%) patients were positive for antiheparin/PF4 IgG. These 13 patients were negative for platelet-activating antibody and had low-heparin-induced thrombocytopenia probability scores. Patients with antiheparin/PF4 IgG were older and had lower antithrombin levels than patients without antiheparin/PF4 IgG. Patients with antiheparin/PF4 IgG had a higher risk of mortality than those without antiheparin/PF4 IgG. The presence of antiheparin/PF4 IgG in old age or low antithrombin level patients with DIC with old age or low antithrombin level suggests a poor prognosis.
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea lukekhk@snu.ac.kr.
authors.forename: Hyun Kyung
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyou Sup
authors.initials: KS
authors.lastname: Han
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000276:immunology* / Q000401:mortality; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010978:Platelet Factor 4 / Q000037:antagonists & inhibitors* / Q000276:immunology*; D011379:Prognosis; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology / Q000276:immunology
chemical_list: D007074:Immunoglobulin G; D010978:Platelet Factor 4; D006493:Heparin
keywords: antiheparin/PF4 antibody; disseminated intravascular coagulation; heparin-induced thrombocytopenia; prognosis