Determination of heparin–platelet factor 4–IgG antibodies improves diagnosis of heparin‐induced thrombocytopenia
Only a few patients with heparin‐induced antibodies develop heparin‐induced thrombocytopenia (HIT). In this study, we investigated whether different immunglobulin classes can be used to differentiate between antibody‐positive patients with and without HIT. Four different patient populations were inv...
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| Veröffentlicht in: | British journal of haematology 2001-06, Vol.113 (4), p.886-890 |
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| creator | Lindhoff‐Last, E. Gerdsen, F. Ackermann, H. Bauersachs, R. |
| description | Only a few patients with heparin‐induced antibodies develop heparin‐induced thrombocytopenia (HIT). In this study, we investigated whether different immunglobulin classes can be used to differentiate between antibody‐positive patients with and without HIT. Four different patient populations were investigated: 32 patients with the immune type of HIT with thromboembolic complications, 13 patients with HIT without thromboembolism, 24 patients with heparin–platelet factor 4 (PF4) antibodies without clinical symptoms of HIT, and 20 heparin‐treated patients with thrombocytopenia caused by other reasons. In all patients the immunglobulin mixture of IgG, IgM and IgA, and the single immunglobulin classes of heparin–PF4 antibodies, were investigated. No significant differences between HIT patients with thromboembolic complications and patients with isolated HIT were found concerning the different immunglobulin classes. Antibody‐positive patients with HIT had significantly higher levels of IgG antibodies than those without HIT (P |
| doi_str_mv | 10.1046/j.1365-2141.2001.02869.x |
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In this study, we investigated whether different immunglobulin classes can be used to differentiate between antibody‐positive patients with and without HIT. Four different patient populations were investigated: 32 patients with the immune type of HIT with thromboembolic complications, 13 patients with HIT without thromboembolism, 24 patients with heparin–platelet factor 4 (PF4) antibodies without clinical symptoms of HIT, and 20 heparin‐treated patients with thrombocytopenia caused by other reasons. In all patients the immunglobulin mixture of IgG, IgM and IgA, and the single immunglobulin classes of heparin–PF4 antibodies, were investigated. No significant differences between HIT patients with thromboembolic complications and patients with isolated HIT were found concerning the different immunglobulin classes. Antibody‐positive patients with HIT had significantly higher levels of IgG antibodies than those without HIT (P < 0·05), while they did not differ concerning IgM and IgA antibodies. By determining IgG antibodies, the specificity of the enzyme‐linked immunosorbent assay (ELISA) system was increased without loss of sensitivity. Heparin–PF4–IgG antibodies can identify patients at risk of developing life‐threatening HIT. Future ELISAs should only include this immunglobulin class, as the determination of the antibody mixture may lead to overestimation of HIT.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1046/j.1365-2141.2001.02869.x</identifier><identifier>PMID: 11442479</identifier><identifier>CODEN: BJHEAL</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Aged ; Aged, 80 and over ; Antibodies - blood ; Antigen-Antibody Complex - analysis ; Biological and medical sciences ; Drug toxicity and drugs side effects treatment ; ELISA ; Enzyme-Linked Immunosorbent Assay - methods ; Hematology ; Heparin - adverse effects ; Heparin - immunology ; heparin‐induced thrombocytopenia ; heparin–PF4 antibodies ; Humans ; immunglobulin class ; Immunoglobulin G - analysis ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Platelet Factor 4 - immunology ; Sensitivity and Specificity ; Thrombocytopenia - chemically induced ; Thrombocytopenia - diagnosis ; thrombosis ; Toxicity: blood</subject><ispartof>British journal of haematology, 2001-06, Vol.113 (4), p.886-890</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright Blackwell Scientific Publications Ltd. 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In this study, we investigated whether different immunglobulin classes can be used to differentiate between antibody‐positive patients with and without HIT. Four different patient populations were investigated: 32 patients with the immune type of HIT with thromboembolic complications, 13 patients with HIT without thromboembolism, 24 patients with heparin–platelet factor 4 (PF4) antibodies without clinical symptoms of HIT, and 20 heparin‐treated patients with thrombocytopenia caused by other reasons. In all patients the immunglobulin mixture of IgG, IgM and IgA, and the single immunglobulin classes of heparin–PF4 antibodies, were investigated. No significant differences between HIT patients with thromboembolic complications and patients with isolated HIT were found concerning the different immunglobulin classes. Antibody‐positive patients with HIT had significantly higher levels of IgG antibodies than those without HIT (P < 0·05), while they did not differ concerning IgM and IgA antibodies. By determining IgG antibodies, the specificity of the enzyme‐linked immunosorbent assay (ELISA) system was increased without loss of sensitivity. Heparin–PF4–IgG antibodies can identify patients at risk of developing life‐threatening HIT. Future ELISAs should only include this immunglobulin class, as the determination of the antibody mixture may lead to overestimation of HIT.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies - blood</subject><subject>Antigen-Antibody Complex - analysis</subject><subject>Biological and medical sciences</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>ELISA</subject><subject>Enzyme-Linked Immunosorbent Assay - methods</subject><subject>Hematology</subject><subject>Heparin - adverse effects</subject><subject>Heparin - immunology</subject><subject>heparin‐induced thrombocytopenia</subject><subject>heparin–PF4 antibodies</subject><subject>Humans</subject><subject>immunglobulin class</subject><subject>Immunoglobulin G - analysis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Factor 4 - immunology</subject><subject>Sensitivity and Specificity</subject><subject>Thrombocytopenia - chemically induced</subject><subject>Thrombocytopenia - diagnosis</subject><subject>thrombosis</subject><subject>Toxicity: blood</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1u1DAURi0EokPhFVCE2CbYjmMnCxZQoC2qxKZ7y7GvW48SO9ie0tnxCEi8IU-Cw4z42bHylX2-71oHoYrghmDGX20b0vKupoSRhmJMGkx7PjT3D9Dm98NDtMEYi7oE-hP0JKVtAVvckcfohBDGKBPDBt29gwxxdl5lF3wVbHULi4rO__j6fZlUhglyZZXOIVas3F3enFfKZzcG4yBVbl5iuCuDcerGh-TSPxXfnDc7DabKtzHMY9D7HBbwTj1Fj6yaEjw7nqfo-sP767OL-urT-eXZm6tas14MtRaK2BGU6Rgfx9ZaaqzgI6ZA8TD0HWDQ3HSEEKGw6DkXhmrdiw4opYa3p-jFobb88vMOUpbbsIu-bJRk6HlHWsEK1B8gHUNKEaxcoptV3EuC5apbbuVqVa5W5apb_tIt70v0-bF_N85g_gSPfgvw8giopNVko_Lapb84QhnHBXt9wL64Cfb_vV--_XixTu1P9iyf1Q</recordid><startdate>200106</startdate><enddate>200106</enddate><creator>Lindhoff‐Last, E.</creator><creator>Gerdsen, F.</creator><creator>Ackermann, H.</creator><creator>Bauersachs, R.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><general>Blackwell Publishing Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>200106</creationdate><title>Determination of heparin–platelet factor 4–IgG antibodies improves diagnosis of heparin‐induced thrombocytopenia</title><author>Lindhoff‐Last, E. ; Gerdsen, F. ; Ackermann, H. ; Bauersachs, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4879-c7a1fbead546bb3ff2df76b02e209985e0ec6d51117a078667d2cc875e222d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies - blood</topic><topic>Antigen-Antibody Complex - analysis</topic><topic>Biological and medical sciences</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>ELISA</topic><topic>Enzyme-Linked Immunosorbent Assay - methods</topic><topic>Hematology</topic><topic>Heparin - adverse effects</topic><topic>Heparin - immunology</topic><topic>heparin‐induced thrombocytopenia</topic><topic>heparin–PF4 antibodies</topic><topic>Humans</topic><topic>immunglobulin class</topic><topic>Immunoglobulin G - analysis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Factor 4 - immunology</topic><topic>Sensitivity and Specificity</topic><topic>Thrombocytopenia - chemically induced</topic><topic>Thrombocytopenia - diagnosis</topic><topic>thrombosis</topic><topic>Toxicity: blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lindhoff‐Last, E.</creatorcontrib><creatorcontrib>Gerdsen, F.</creatorcontrib><creatorcontrib>Ackermann, H.</creatorcontrib><creatorcontrib>Bauersachs, R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lindhoff‐Last, E.</au><au>Gerdsen, F.</au><au>Ackermann, H.</au><au>Bauersachs, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determination of heparin–platelet factor 4–IgG antibodies improves diagnosis of heparin‐induced thrombocytopenia</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2001-06</date><risdate>2001</risdate><volume>113</volume><issue>4</issue><spage>886</spage><epage>890</epage><pages>886-890</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><coden>BJHEAL</coden><abstract>Only a few patients with heparin‐induced antibodies develop heparin‐induced thrombocytopenia (HIT). In this study, we investigated whether different immunglobulin classes can be used to differentiate between antibody‐positive patients with and without HIT. Four different patient populations were investigated: 32 patients with the immune type of HIT with thromboembolic complications, 13 patients with HIT without thromboembolism, 24 patients with heparin–platelet factor 4 (PF4) antibodies without clinical symptoms of HIT, and 20 heparin‐treated patients with thrombocytopenia caused by other reasons. In all patients the immunglobulin mixture of IgG, IgM and IgA, and the single immunglobulin classes of heparin–PF4 antibodies, were investigated. No significant differences between HIT patients with thromboembolic complications and patients with isolated HIT were found concerning the different immunglobulin classes. Antibody‐positive patients with HIT had significantly higher levels of IgG antibodies than those without HIT (P < 0·05), while they did not differ concerning IgM and IgA antibodies. By determining IgG antibodies, the specificity of the enzyme‐linked immunosorbent assay (ELISA) system was increased without loss of sensitivity. Heparin–PF4–IgG antibodies can identify patients at risk of developing life‐threatening HIT. Future ELISAs should only include this immunglobulin class, as the determination of the antibody mixture may lead to overestimation of HIT.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11442479</pmid><doi>10.1046/j.1365-2141.2001.02869.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Antibodies - blood Antigen-Antibody Complex - analysis Biological and medical sciences Drug toxicity and drugs side effects treatment ELISA Enzyme-Linked Immunosorbent Assay - methods Hematology Heparin - adverse effects Heparin - immunology heparin‐induced thrombocytopenia heparin–PF4 antibodies Humans immunglobulin class Immunoglobulin G - analysis Medical sciences Middle Aged Pharmacology. Drug treatments Platelet Factor 4 - immunology Sensitivity and Specificity Thrombocytopenia - chemically induced Thrombocytopenia - diagnosis thrombosis Toxicity: blood |
| title | Determination of heparin–platelet factor 4–IgG antibodies improves diagnosis of heparin‐induced thrombocytopenia |
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