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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sheridan, D. Articles by Kelton, J. G. Search for Related Content PubMed PubMed Citation Articles by Sheridan, D. Articles by Kelton, J. G. Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  A diagnostic test for heparin-induced thrombocytopenia D Sheridan, C Carter and JG Kelton Heparin-induced thrombocytopenia can be a serious and difficult-to- diagnose complication of heparin therapy. Serum from patients with heparin-induced thrombocytopenia can cause heparin-dependent platelet aggregation, but the low sensitivity and specificity of this test limit its clinical usefulness. In this report we describe an assay for heparin-induced thrombocytopenia that is both sensitive and specific. The improvement in the assay was accomplished by measuring platelet release instead of aggregation and by measuring platelet release at two heparin concentrations. The rationale for the use of two heparin concentrations was that sera from patients with heparin-induced thrombocytopenia caused release at therapeutic but not at high concentrations of heparin. Twenty-eight sera samples from patients suspected of having heparin-induced thrombocytopenia and 573 controls were coded and tested in the assay. The patients with possible heparin- induced thrombocytopenia were ranked according to the likelihood of having this disorder by using prospectively defined criteria. The test had a high specificity (99%); only one of 573 controls showed a positive result. The test was also very sensitive, and the likelihood of a positive test result was directly correlated with the clinical likelihood of the patient having heparin-induced thrombocytopenia. Six of six patients with definitive heparin-induced thrombocytopenia had positive test results, whereas zero of four patients in whom the diagnosis was unlikely had positive test results. The two-point test for heparin-induced thrombocytopenia represents a sensitive and specific test for this disorder. This test may be useful not only in confirming the diagnosis of this disorder but also may provide information about its pathogenesis. Volume 67, Issue 1, pp. 27-30, 01/01/1986 Copyright © 1986 by The American Society of Hematology CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: E. Shantsila, G. Y. H. Lip, and B. H. 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Walenga, W. P. Jeske, and J. Fareed Heparin-induced Thrombocytopenia: Clinical Considerations of Alternative Anticoagulation with Various Glycosaminoglycans and Thrombin Inhibitors Clinical and Applied Thrombosis/Hemostasis, January 1, 1999; 5(1): 52 - 59. [Abstract] [PDF] L. Ziporen, Z.Q. Li, K.S. Park, P. Sabnekar, W.Y. Liu, G. Arepally, Y. Shoenfeld, T. Kieber-Emmons, D.B. Cines, and M. Poncz Defining an Antigenic Epitope on Platelet Factor 4 Associated With Heparin-Induced Thrombocytopenia Blood, November 1, 1998; 92(9): 3250 - 3259. [Abstract] [Full Text] [PDF] L. E. Carlsson, S. Santoso, G. Baurichter, H. Kroll, S. Papenberg, P. Eichler, N. A.C. Westerdaal, V. Kiefel, J. G.J. van de Winkel, and A. Greinacher Heparin-Induced Thrombocytopenia: New Insights Into the Impact of the Fcgamma RIIa-R-H131 Polymorphism Blood, September 1, 1998; 92(5): 1526 - 1531. [Abstract] [Full Text] [PDF] J.-S. Suh, R. H. Aster, and G. P. Visentin Antibodies From Patients With Heparin-Induced Thrombocytopenia/Thrombosis Recognize Different Epitopes on Heparin: Platelet Factor 4  Blood, February 1, 1998; 91(3): 916 - 922. [Abstract] [Full Text] [PDF] J. Polgar, P. Eichler, A. Greinacher, and K. J. Clemetson Adenosine Diphosphate (ADP) and ADP Receptor Play a Major Role in Platelet Activation/Aggregation Induced by Sera From Heparin-Induced Thrombocytopenia Patients Blood, January 15, 1998; 91(2): 549 - 554. [Abstract] [Full Text] [PDF] D. Cummins and E. Hill Heparin-Induced Thrombocytopenia Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 1997; 1(4): 349 - 365. [Abstract] [PDF] T. L. Bauer, G. Arepally, B. A. Konkle, B. Mestichelli, S. S. Shapiro, D. B. Cines, M. Poncz, S. McNulty, J. Amiral, W. W. Hauck, et al. Prevalence of Heparin-Associated Antibodies Without Thrombosis in Patients Undergoing Cardiopulmonary Bypass Surgery Circulation, March 4, 1997; 95(5): 1242 - 1246. [Abstract] [Full Text] G. Arepally, S. E. McKenzie, X.-M. Jiang, M. Poncz, and D. B. Cines Fcgamma RIIA H/R131 Polymorphism, Subclass-Specific IgG Anti-Heparin/Platelet Factor 4 Antibodies and Clinical Course in Patients With Heparin-Induced Thrombocytopenia and Thrombosis Blood, January 15, 1997; 89(2): 370 - 375. [Abstract] [Full Text] [PDF] S. S. Farag, H. Savoia, C. J. O'Malley, and K. M. McGrath Lack of In Vitro Cross-Reactivity Predicts Safety of Low-Molecular Weight Heparins in Heparin-Induced Thrombocytopenia Clinical and Applied Thrombosis/Hemostasis, January 1, 1997; 3(1): 58 - 62. [Abstract] [PDF] J. Hirsh and J. Hoak Management of Deep Vein Thrombosis and Pulmonary Embolism : A Statement for Healthcare Professionals From the Council on Thrombosis (in Consultation With the Council on Cardiovascular Radiology), American Heart Association Circulation, June 15, 1996; 93(12): 2212 - 2245. [Full Text] M. J. Wilhelm, C. Schmid, D. Kececioglu, T. Mollhoff, H. Ostermann, and H. H. Scheld Cardiopulmonary Bypass in Patients With Heparin-Induced Thrombocytopenia Using Org 10172 Ann. Thorac. Surg., March 1, 1996; 61(3): 920 - 924. [Abstract] [Full Text] T. E. Warkentin, M. N. Levine, J. Hirsh, P. Horsewood, R. S. Roberts, M. Gent, and J. G. Kelton Heparin-Induced Thrombocytopenia in Patients Treated with Low-Molecular-Weight Heparin or Unfractionated Heparin N. Engl. J. Med., May 18, 1995; 332(20): 1330 - 1336. [Abstract] [Full Text] [PDF] D. Brent Kerns, P. A. Frymoyer, R. T. Kopecky, D. Tice, M. F. Fillinger, D. Bruch, and R. A. Schwartz Is Heparin-Induced Platelet Activation an Unrecognized Cause of Thrombosis in Chronic Dialysis Patients? Vascular and Endovascular Surgery, July 1, 1992; 26(6): 487 - 493. [Abstract] [PDF] M. Sobel Heparin-Induced Thrombocytopenia Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1992; 5(2): 1 - 27. [PDF] E. G. Wittels, R. D. Siegel, and E. M. Mazur Thrombocytopenia in the Intensive Care Unit Setting J Intensive Care Med, September 1, 1990; 5(5): 224 - 240. [Abstract] [PDF] S. Nand and E. Hines Jr. Heparin-Associated Thrombocytopenia and Immunoglobulin Therapy Ann Intern Med, March 15, 1990; 112(6): 473 - 474. [Abstract] [PDF] J. N. Frame, K. P. Mulvey, J. C. Phares, and M. J. Anderson Correction of Severe Heparin-Associated Thrombocytopenia with Intravenous Immunoglobulin Ann Intern Med, December 1, 1989; 111(11): 946 - 947. [Abstract] [PDF]

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