Rare Diseases Symptoms Automatic Extraction
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Rapid exclusion of the diagnosis of immune HIT by AcuStar HIT and heparin-induced multiple electrode aggregometry.
[heparin-induced thrombocytopenia]
Accurate
diagnosis
of
heparin-induced
thrombocytopenia
(
HIT
)
is
essential
but
remains
challenging
.
We
have
previously
demonstrated
,
in
a
retrospective
study
,
the
usefulness
of
the
combination
of
the
4
Ts
score
,
AcuStar
HIT
and
heparin-induced
multiple
electrode
aggregometry
(
HIMEA
)
with
optimized
thresholds
.
We
aimed
at
exploring
prospectively
the
performances
of
our
optimized
diagnostic
algorithm
on
suspected
HIT
patients
.
The
secondary
objective
is
to
evaluate
performances
of
AcuStar
HIT
-
Ab
(
PF
4
-
H
)
in
comparison
with
the
clinical
outcome
.
116
inpatients
with
clinically
suspected
immune
HIT
were
included
.
Our
optimized
diagnostic
algorithm
was
applied
to
each
patient
.
Sensitivity
,
specificity
,
negative
predictive
value
(
NPV
)
,
positive
predictive
value
(
PPV
)
of
the
overall
diagnostic
strategy
as
well
as
AcuStar
HIT
-
Ab
(
at
manufacturer
's
thresholds
and
at
our
thresholds
)
were
calculated
using
clinical
diagnosis
as
the
reference
.
Among
116
patients
,
2
patients
had
clinically-diagnosed
HIT
.
These
2
patients
were
positive
on
AcuStar
HIT
-
Ab
,
AcuStar
HIT
-IgG
and
HIMEA
.
Using
our
optimized
algorithm
,
all
patients
were
correctly
diagnosed
.
AcuStar
HIT
-
Ab
at
our
cut-off
(
>
9
.
41
U
/
mL
)
and
at
manufacturer
's
cut-off
(
>
1
.
00
U
/
mL
)
showed
both
a
sensitivity
of
100
.
0
%
and
a
specificity
of
99
.
1
%
and
90
.
4
%
,
respectively
.
The
combination
of
the
4
Ts
score
,
the
HemosIL
®
AcuStar
HIT
and
HIMEA
with
optimized
thresholds
may
be
useful
for
the
rapid
and
accurate
exclusion
of
the
diagnosis
of
immune
HIT
.
Diseases
Validation
Diseases presenting
"secondary objective"
symptom
congenital toxoplasmosis
cystinuria
heparin-induced thrombocytopenia
phenylketonuria
primary effusion lymphoma
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