A Flow Cytometric Assay of Platelet Activation Marker P-Selectin (CD62P) Distinguishes Heparin-induced Thrombocytopenia (HIT) from HIT with Thrombosis (HITT)

Wenche Jy; Wei Wei Mao; Lawrence L. Horstman; Peter A. Valant; Yeon S. Ahn

doi:10.1055/s-0037-1614371

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 82(04): 1255-1259
DOI: 10.1055/s-0037-1614371

Review Article

Schattauer GmbH

A Flow Cytometric Assay of Platelet Activation Marker P-Selectin (CD62P) Distinguishes Heparin-induced Thrombocytopenia (HIT) from HIT with Thrombosis (HITT)

Wenche Jy

¹From the Wallace H. Coulter Platelet Laboratory University of Miami School of Medicine, Miami, Florida, USA

,

Wei Wei Mao

¹From the Wallace H. Coulter Platelet Laboratory University of Miami School of Medicine, Miami, Florida, USA

,

Lawrence L. Horstman

¹From the Wallace H. Coulter Platelet Laboratory University of Miami School of Medicine, Miami, Florida, USA

,

Peter A. Valant

¹From the Wallace H. Coulter Platelet Laboratory University of Miami School of Medicine, Miami, Florida, USA

,

Yeon S. Ahn

¹From the Wallace H. Coulter Platelet Laboratory University of Miami School of Medicine, Miami, Florida, USA

› Author Affiliations

Abstract

Summary

Heparin induced thrombocytopenia (HIT) is a well-known complication of heparin administration but usually resolves upon discontinuation without sequelae. However, a small proportion of HIT patients develop thrombosis associated with HIT, designated as HITT, which is often life-threatening and may lead to gangrene and amputations. Existing laboratory methods of confirming HIT/HITT do not distinguish between HIT and HITT. We report a flow cytometric assay of platelet activation marker CD62P to distinguish the effects of addition of HIT vs. HITT plasma to normal blood. Briefly, normal whole blood was incubated with platelet-poor plasma from 12 patients with HITT, 30 with HIT, and 65 controls, in presence and absence of heparin, and expression of CD62P was assayed by flow cytometry. When the ratios of fluorescent intensity of CD62P with heparin divided by that without heparin were compared, HITT plasma induced significantly higher ratios than HIT plasma (HITT ratios ~2.5 vs. HIT ratios ~1.2; p <0.001). Eleven of 12 HITT patients were positive by this test but only 5 of 30 HIT patients were positive (p < 0.0005). In a case of HIT with silent thrombosis, this assay gave a positive results prior to clinically evident thrombosis. In conclusion, this method distinguishes HITT from HIT and may be clinically useful in the detection of HITT, allowing early intervention for preventing catastrophic thrombosis.

Keywords

Heparin-induced thrombocytopenia - thrombosis - thrombocytopenia - drug-induced antibodies - heparin - platelet activation - P-selectin - CD62 - CD36

Full Text

References

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