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Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin therapy. It represents initially as thrombocytopenia and is associated with venous or arterial thrombosis. It has been reported that platelet factor 4/heparin complex antibody plays an important role in the pathogenesis of HIT. Patients on hemodialysis have a high risk of developing HIT because heparin is administrated in hemodialysis as anticoagulant. Thrombocytopenia usually occurs 5 to 10 days after the onset of administration, but occasionally, it may occur rapidly in patients who have preformed antibodies from recent heparin use. We report here 2 cases of HIT with platelet factor 4-heparin reactive antibody in hemodialysis patients.
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http://dx.doi.org/10.3343/kjlm.2006.26.5.334 | DOI Listing |
N Engl J Med
September 2025
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
Background: Heparin-induced thrombocytopenia (HIT) is an immune-mediated platelet disorder caused by antibodies that target complexes of platelet factor 4 (PF4) and heparin. HIT has been characterized as a polyclonal immune response; however, studies of other rare anti-PF4 disorders have identified clonally restricted antibodies.
Methods: In this study, we investigated the clonality of pathogenic HIT antibodies.
Thromb Res
August 2025
Institute for Clinical and Experimental Transfusion Medicine, Tuebingen, Germany; Center for Clinical Transfusion Medicine, University Hospital of Tuebingen, Tuebingen, Germany.
Introduction: Congenital or acquired dysregulation of fibrinolytic system can lead to bleeding (hyperfibrinolysis) or thrombosis (hypofibrinolysis), with increased risk for multi-organ failure. Standard clotting-based assays provide limited insight into fibrinolytic status. In contrast, thromboelastography (TEG), a whole blood assay, offers a comprehensive assessment of the coagulation and fibrinolytic systems.
View Article and Find Full Text PDFAdv Biol (Weinh)
August 2025
Institute for Bioprocessing and Analytical Measurement Techniques, 37308, Heilbad Heiligenstadt, Germany.
Accurate detection of heparin-induced thrombocytopenia (HIT) antibodies is crucial for diagnosing and managing thrombotic events. Conventional immunoassays, however, often lack specificity and require confirmatory testing with fresh human platelets. To address this limitation, we optimized our previously developed cell-based enzyme-linked immunosorbent assay (ELISA) for improved HIT detection under various experimental conditions.
View Article and Find Full Text PDFCureus
July 2025
Anesthesiology and Center for Outcomes Research, University of Texas Health Science Center, Houston, USA.
Heparin-induced thrombocytopenia (HIT) is a rare but serious immune-mediated complication of heparin therapy, often resulting in thrombotic events despite adequate anticoagulation. Rapid-onset HIT is a particularly severe variant that occurs within 24 hours of re-exposure to heparin in sensitized individuals with circulating anti-platelet factor 4 (PF4)/heparin antibodies. Although rare, its potential for rapid progression and fatal outcomes necessitates a high index of clinical suspicion, especially in perioperative settings involving routine heparin use.
View Article and Find Full Text PDFWe describe a rare case of a 64-year-old male who developed life-threatening thrombocytopenia two weeks after undergoing endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm. He presented with mucocutaneous bleeding manifestations, and laboratory findings revealed a critically low platelet count (<2 × 10/L). An extensive workup identified a positive stool antigen test and autoimmune markers, including antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies.
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