抗 PF4 酶联免疫吸附试验阴性、SRA 阳性肝素诱导的血小板减少症

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-05-09 DOI:10.3390/hematolrep16020029

A. Attah, Chelsea Peterson, Max W. Jacobs, Rama Bhagavatula, Deep Shah, Robert Kaplan, Y. Samhouri

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引用次数: 0

摘要

肝素产品常用于住院病人预防和治疗静脉血栓栓塞，但同时也会给患者带来肝素诱发血小板减少症（HIT）的风险。4Ts 评分可确定 HIT 的检测前概率。通过抗血小板因子（PF4）免疫测定筛查和血清素释放测定（SRA）确诊。抗血小板因子检测的灵敏度较高（98%），但特异性较低（50%），而且经常出现假阳性检测结果。我们介绍了本院一例罕见的抗-PF4-多聚酶联免疫吸附试验阴性、血清素释放试验阳性的 HIT 患者，并描述了及时诊断该病例所面临的挑战。

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Anti-PF4 ELISA-Negative, SRA-Positive Heparin-Induced Thrombocytopenia

Heparin products are frequently used in the inpatient setting to prevent and treat venous thromboembolism, but they simultaneously put patients at risk of developing heparin-induced thrombocytopenia (HIT). The 4Ts score determines the pretest probability of HIT. Diagnosis is made with a screening antiplatelet factor (PF4) immunoassay and the serotonin-release assay (SRA) as a confirmatory test. Anti-PF4 assays have high sensitivity (98%) but lower specificity (50%) and result in frequent false-positive tests. We present a rare case from our institution of a patient with anti-PF4–Polyanion ELISA-negative, SRA-positive HIT and describe the challenges in making a timely diagnosis in this case.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.