Flow cytometry vs conventional methods for the evaluation of anti-PF4/heparin antibodies: a single center study

Bioanalysis. 2024;16(15):813-823. doi: 10.1080/17576180.2024.2373571. Epub 2024 Jul 18.

Abstract

Aim: Heparin-induced thrombocytopenia (HIT) is a rare, life-threatening, immune-mediated adverse effect of heparin administration. This study compares frequently used laboratory assays in terms of their effectiveness in HIT diagnosis.Materials & methods: Fifty patients with suspected HIT were tested by gel immunoassay and solid phase PF4/heparin antibody ELISA. On positive results, platelet activation markers P-selectin and Annexin V were assayed using flow cytometry.Results: Thirty/50 patients were negative for both immunoassays. Flow cytometry was performed in the 20 immunoassay positive patients. Platelet activation was observed in 7/20 in the presence of low heparin concentration (0.2 IU/ml).Conclusion: The results are in accordance with the currently available literature and flow cytometry seems a promising alternative in HIT laboratory investigation.

Keywords: Annexin V; ELISA; P-selectin; PaGIA; anti-PF4/heparin antibodies; flow cytometry; heparin-induced thrombocytopenia; platelet activation.

Plain language summary

[Box: see text].

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antibodies / immunology
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Flow Cytometry* / methods
  • Heparin* / adverse effects
  • Heparin* / immunology
  • Humans
  • Immunoassay / methods
  • Male
  • Middle Aged
  • Platelet Activation / drug effects
  • Platelet Factor 4* / immunology
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / immunology

Substances

  • Heparin
  • Platelet Factor 4
  • Antibodies