Anti-platelet factor 4 immunothrombotic syndromes

Br J Haematol. 2024 Oct;205(4):1291-1295. doi: 10.1111/bjh.19663. Epub 2024 Jul 26.

Abstract

Anti-platelet factor 4 immunothrombotic syndromes comprise a group of disorders that include heparin-induced thrombocytopenia and vaccine-induced immune thrombocytopenia and thrombosis. These are highly prothrombotic, immunological disorders characterised by specific clinical and pathological criteria which include thrombocytopenia and thrombosis. While they are predominantly triggered by heparin and the adenoviral vector vaccines, respectively, other provoking factors have been described, as well as spontaneous forms. The unexplained co-occurrence of thrombocytopenia with thrombosis should raise suspicion and prompt testing. This nutshell review discusses the pathophysiology, presenting features and diagnostic criteria for these conditions.

Keywords: PF4 antibodies; heparin‐induced thrombocytopenia; immunothrombosis; platelet factor 4; vaccine‐induced immune thrombocytopenia and thrombosis.

Publication types

  • Review

MeSH terms

  • Autoantibodies / immunology
  • Heparin* / adverse effects
  • Heparin* / therapeutic use
  • Humans
  • Platelet Factor 4* / immunology
  • Purpura, Thrombocytopenic, Idiopathic / immunology
  • Syndrome
  • Thrombocytopenia / immunology
  • Thrombosis* / etiology
  • Thrombosis* / immunology
  • Vaccines / adverse effects

Substances

  • Heparin
  • Platelet Factor 4
  • Autoantibodies
  • Vaccines