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The advantages and limitations of impedance aggregometry in detection of heparin-induced thrombocytopenia.
[heparin-induced thrombocytopenia]
Heparin-induced
thrombocytopenia
(
HIT
)
represents
a
serious
complication
of
heparin
treatment
.
IgG
antibodies
binding
platelet
factor
4
(
PF
4
)
and
heparin
trigger
the
clinical
manifestations
of
HIT
.
However
,
only
a
portion
of
the
antibodies
have
the
ability
to
activate
platelets
,
and
these
can
be
identified
by
a
platelet
aggregation
test
(
functional
testing
)
.
Current
methods
HIPA
and
SRA
are
time-consuming
and
difficult
if
HIT
is
clinically
suspected
;
therefore
,
numerous
new
methods
have
recently
been
developed
.
To
determine
HIT
,
impedance
aggregometry
using
the
Multiplate
analyzer
(
MEA
)
as
heparin-induced
aggregation
techniques
and
the
Technozym
HIT
Ig
ELISA
test
were
used
.
The
MEA
method
uses
sensitization
of
donor
platelets
with
patient
plasma
in
the
presence
of
heparin
at
a
concentration
of
0
.
5
IU
/
mL
.
The
results
were
compared
with
the
ELISA
test
.
We
examined
190
patients
at
clinically
intermediate
and
higher
risk
of
HIT
according
to
the
4
T
score
.
All
samples
were
examined
by
the
ELISA
test
and
MEA
,
with
positive
samples
being
further
confirmed
by
high
-concentration
heparin
.
The
methodology
was
modified
with
respect
to
the
dilution
for
high
positive
samples
and
assessment
has
been
extended
to
an
index
of
inhibition
.
In
the
studied
group
,
we
demonstrated
that
MEA
has
sufficient
sensitivity
and
higher
specificity
.
In
the
group
of
patients
,
10
.
0
%
showed
positive
results
by
MEA
as
compared
with
7
.
3
%
determined
by
ELISA
.
Unlike
the
ELISA
methods
of
the
same
quality
,
MEA
is
more
suitable
for
detecting
platelet
-activating
HIT
antibodies
in
practice
.
Diseases
Validation
Diseases presenting
"high-concentration heparin"
symptom
heparin-induced thrombocytopenia
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