Heparin-induced thrombocytopenia (HIT) is a disorder characterized by antibody-mediated
platelet activation and vascular thrombosis in patients exposed to heparin. Traditionally,
the diagnosis is supported by platelet-factor 4 (PF4)/heparin enzyme-immunoassay (EIA)
and confirmed with a functional assay, like the serotonin release assay (SRA). We
describe a patient with a clinical course highly suspicious for HIT despite an initially
weakly positive, then negative, PF4 antibody and repeatedly negative SRA. This should
alert clinicians to the growing evidence of double-negative (PF4 negative/SRA negative)
HIT as a clinical entity.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Serotonin-release assay-negative heparin-induced thrombocytopenia.Am J Hematol. 2020; 95: 38-47https://doi.org/10.1002/ajh.25660
- A novel PF4-dependent platelet activation assay identifies patients likely to have heparin-induced thrombocytopenia/thrombosis.Chest. 2016; 150: 506-515https://doi.org/10.1016/j.chest.2016.02.641
- PF4/polyanion ELISA-negative antibodies to PF4 and non-PF4 targets can mediate platelet activation and cause heparin-induced thrombocytopenia (HIT).Res Pract Thromb Haemost. 2021; 5
Article info
Publication history
Published online: October 14, 2022
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.