Lab Medicine Rounds Advances in the diagnosis of heparin-induced thrombocytopenia
Nov 13, 2020
Anand Padmanabhan, a physician scientist at the Mayo Clinic, dives into the intricate world of heparin-induced thrombocytopenia (HIT). He discusses the critical importance of accurate diagnosis to prevent serious complications. The conversation highlights the limitations of current testing methods like ELISA and explores innovative solutions, including the promising P-selectin expression assay. Padmanabhan emphasizes the value of interdisciplinary collaboration in advancing diagnostic practices and shares insights on the future of HIT testing.
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Critical Need for Accurate HIT Diagnosis
- HIT is a dangerous side effect of heparin that causes blood clots and high mortality risk.
- Accurate diagnosis is critical as treatments carry risks and misdiagnosis can lead to harmful outcomes.
Limitations of HIT Laboratory Testing
- ELISA tests for HIT antibodies are highly sensitive but have many false positives.
- Serotonin release assay (SRA) confirms diagnosis but is complex, slow, and available only in few labs.
Advancement with PF4-Dependent Assay
- New PF4-dependent assay (PEA) is simpler, uses fewer platelets, and matches or exceeds SRA accuracy.
- It can detect pathogenic HIT antibodies earlier than the SRA test.