Diagnostic value of antibody-induced procoagulant platelets in heparin-induced thrombocytopenia: communication from the ISTH SSC Subcommittee on Platelet Immunology

Jan Zlamal; Alessandro Aliotta; Lorenzo Alberio; Vivien Chen; Tamam Bakchoul; SSC Platelet Immunology of the ISTH

doi:10.1016/j.jtha.2023.11.019

Diagnostic value of antibody-induced procoagulant platelets in heparin-induced thrombocytopenia: communication from the ISTH SSC Subcommittee on Platelet Immunology

J Thromb Haemost. 2024 Mar;22(3):860-868. doi: 10.1016/j.jtha.2023.11.019. Epub 2023 Dec 7.

Authors

Jan Zlamal¹, Alessandro Aliotta², Lorenzo Alberio², Vivien Chen³, Tamam Bakchoul⁴; SSC Platelet Immunology of the ISTH

Collaborators

SSC Platelet Immunology of the ISTH:
Ishac Nazy, Hanny Al-Samkari, Steven McKenzie, Claire Pouplard, Ruchika Sharma

Affiliations

¹ Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tübingen, University of Tübingen, Tübingen, Germany; Centre for Clinical Transfusion Medicine, Tübingen, Germany.
² Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
³ ANZAC Research Institute, Sydney Local Health District, Sydney, New South Wales, Australia; Department of Haematology, Concord Repatriation General Hospital and NSW Health Pathology, Sydney, New South Wales, Australia; Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia.
⁴ Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tübingen, University of Tübingen, Tübingen, Germany; Centre for Clinical Transfusion Medicine, Tübingen, Germany. Electronic address: tamam.bakchoul@med.uni-tuebingen.de.

PMID: 38065529
DOI: 10.1016/j.jtha.2023.11.019

Abstract

Heparin-induced thrombocytopenia (HIT) is an immune-mediated prothrombotic disorder characterized by a drop in platelet count and an increased risk of thromboembolic events. The accurate diagnosis of HIT involves clinical assessment and laboratory testing with well-characterized functional tests. Recent research has shown the potential of investigating procoagulant platelet formation induced by HIT antibodies. To successfully implement these assays in clinical laboratories, careful consideration of technical and preanalytical factors is crucial. In this communication from the SSC Platelet Immunology, we provide a consensus from experts on the use of flow cytometry in HIT diagnosis, highlighting the importance of standardized protocols.

Keywords: blood platelets; diagnostic tests routine; flow cytometry; heparin; platelet activation.

Publication types

Practice Guideline

MeSH terms

Antibodies
Blood Platelets
Communication
Heparin* / adverse effects
Humans
Platelet Count
Platelet Factor 4
Thrombocytopenia* / chemically induced
Thrombocytopenia* / diagnosis

Substances

Heparin
Antibodies
Platelet Factor 4