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001-es BibID:	BIBFORM062383
Első szerző:	Kerényi Adrienne (laboratóriumi szakorvos)
Cím:	Evaluation of flow cytometric HIT assays in relation to an IgG-specific immunoassay and clinical outcome / Adrienne Kerényi, Ildikó Beke Debreceni, Zsolt Oláh, Péter Ilonczai, Zsuzsanna Bereczky, Béla Nagy Jr., László Muszbek, János Kappelmayer
Dátum:	2017
ISSN:	1552-4949
Megjegyzések:	BACKGROUND:Heparin-induced thrombocytopenia (HIT) is a severe side effect of heparin treatment caused by platelet activating IgG antibodies generated against the platelet factor 4 (PF4)-heparin complex. Thrombocytopenia and thrombosis are the leading clinical symptoms of HIT.METHODS:The clinical pretest probability of HIT was evaluated by the 4T score system. Laboratory testing of HIT was performed by immunological detection of antibodies against PF4-heparin complex (EIA) and two functional assays. Heparin-dependent activation of donor platelets by patient plasma was detected by flow cytometry. Increased binding of Annexin-V to platelets and elevated number of platelet-derived microparticles (PMP) were the indicators of platelet activation.RESULTS:EIA for IgG isotype HIT antibodies was performed in 405 suspected HIT patients. Based on negative EIA results HIT was excluded in 365 (90%) of cases. In 40 patients with positive EIA test result functional tests were performed. Platelet activating antibodies were detected in 17 cases by Annexin V binding. PMP count analysis provided nearly identical results. The probability of a positive flow cytometric assay result was higher in patients with elevated antibody titer. 71% of patients with positive EIA and functional assay had thrombosis.CONCLUSIONS:EIA is an important first line laboratory test in the diagnosis of HIT, however, HIT must be confirmed by a functional test. Annexin V binding and PMP assays using flow cytometry are functional HIT tests convenient in a clinical diagnostic laboratory. The positive results of functional assays may predict the onset of thrombosis. This article is protected by copyright. All rights reserved.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban heparin-induced thrombocytopenia thrombosis 4T score flow cytometry platelet microparticles
Megjelenés:	Cytometry Part B-Clinical Cytometry. - 92 : 5 (2017), p. 389-397. -
További szerzők:	Bekéné Debreceni Ildikó (1970-) (biológus) Oláh Zsolt (1974-) (belgyógyász) Ilonczai Péter (1977-) (orvos, belgyógyász, haematológus szakorvos) Bereczky Zsuzsanna (1974-) (orvosi laboratóriumi diagnosztika szakorvos) Nagy Béla Jr. (1980-) (labordiagnosztikai szakorvos) Muszbek László (1942-) (haematológus, kutató orvos) Kappelmayer János (1960-) (laboratóriumi szakorvos)
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