{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:29:19Z","timestamp":1774243759248,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Heparin-induced thrombocytopenia (HIT) is a serious adverse effect of heparin treatment caused by platelet-activating anti-platelet factor 4 (PF4)\/heparin antibodies. Accurate diagnosis of HIT is essential but remains challenging. The aim of our study was to explore the performance of our optimized diagnostic laboratory algorithm, based on Chemiluminescence (CliA) and ELISA immunoassays, on suspected HIT patients. The study compared the prevalence of HIT diagnosis in A.O. Mauriziano with the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>163 consecutive patients were investigated for suspected HIT with CliA HemosIL Acustar HIT-IgG, Werfen. HIT was ruled out in all patients with CliA &amp;lt;0.13\u2005U\/mL. All patients with CliA &amp;gt;0.13\u2005U\/mL were further investigated with Zymutest-HIA anti-PF4 IgG ELISA immunoassay. In these patients, HIT was ruled out on the combination of CliA between 0.13 and 1.0\u2005U\/mL followed by ELISA assay &amp;lt;0.300\u2005OD. HIT was ruled in patients whose plasma tested positive or doubtful with CliA and positive with ELISA immunoassay and confirmed positive with a platelet aggregation test (PAT). Suspicion of HIT was revealed with clinical 4Ts score or recent suggestive anamnestic history.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our diagnostic algorithm ruled out HIT diagnosis in 144\/163 patients (88%) and predicted a positive PAT in 5\/19 (26%) of CliA positive (4\/5) or ELISA positive and CliA doubtful (1\/5) patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our prevalence was 3.1%, comparable with the literature. The approach combining 2 quantitative immunoassays\u2019 (CliA and ELISA) results and 4Ts score probability was able to rule out the diagnosis within 1\u2005h in 66% of patients with suspected HIT and within 24\u2005h in 88% of patients. In the remaining 12% of cases, management decisions have to be based on individualized judgment while awaiting functional confirming results (48\u201372\u2005h).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfae062","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T16:53:45Z","timestamp":1720544025000},"page":"940-951","source":"Crossref","is-referenced-by-count":1,"title":["Combination of 2 Quantitative Immunoassays and Clinical Score Algorithm to Reduce False-Negative Results in Heparin-Induced Thrombocytopenia: Prevalence Study of Mauriziano Hospital in Turin, Italy"],"prefix":"10.1093","volume":"9","author":[{"given":"Veronica","family":"Minei","sequence":"first","affiliation":[{"name":"SC Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Valesella","sequence":"additional","affiliation":[{"name":"Dipartimento di patologia clinica e biochimica clinica, Unito , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Papandrea","sequence":"additional","affiliation":[{"name":"SC Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piera","family":"Sivera","sequence":"additional","affiliation":[{"name":"SC Ematologia, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Insana","sequence":"additional","affiliation":[{"name":"SC Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Cosseddu","sequence":"additional","affiliation":[{"name":"SC Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Umurungi","sequence":"additional","affiliation":[{"name":"SC Ematologia, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Montaruli","sequence":"additional","affiliation":[{"name":"SC Laboratorio Analisi, Azienda Ospedaliera Ordine Mauriziano , Turin , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"2024090311500237000_jfae062-B1","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1182\/blood.V98.8.2442","article-title":"Heparin-induced thrombocytopenia\/thrombosis in a transgenic mouse model requires human platelet factor 4 and platelet activation through FcgammaRIIA","volume":"98","author":"Reilly","year":"2001","journal-title":"Blood"},{"key":"2024090311500237000_jfae062-B2","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1056\/NEJMcp1411910","article-title":"CLINICAL PRACTICE. Heparin-induced thrombocytopenia","volume":"373","author":"Greinacher","year":"2015","journal-title":"N Engl J Med"},{"key":"2024090311500237000_jfae062-B3","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.trsl.2020.04.014","article-title":"Pathogenesis of heparin-induced thrombocytopenia","volume":"225","author":"Arepally","year":"2020","journal-title":"Transl Res"},{"key":"2024090311500237000_jfae062-B4","doi-asserted-by":"crossref","first-page":"4963","DOI":"10.1182\/blood-2008-10-186064","article-title":"Studies of the immune response in heparin-induced thrombocytopenia","volume":"113","author":"Warkentin","year":"2009","journal-title":"Blood"},{"key":"2024090311500237000_jfae062-B5","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1182\/bloodadvances.2018024489","article-title":"American society of hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia","volume":"2","author":"Cuker","year":"2018","journal-title":"Blood Adv"},{"key":"2024090311500237000_jfae062-B6","first-page":"14","article-title":"Heparin induced thrombocytopenia: position paper from the Italian Society on Thrombosis and Haemostasis (SISET)","volume":"19","author":"Marcucci","year":"2021","journal-title":"Blood Transfus"},{"key":"2024090311500237000_jfae062-B7","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.3390\/jcm9041226","article-title":"Detection of platelet-activating antibodies associated with heparin-induced thrombocytopenia","volume":"9","author":"Tardy","year":"2020","journal-title":"J Clin Med"},{"key":"2024090311500237000_jfae062-B8","first-page":"1171","article-title":"Rapid and accurate Bayesian diagnosis of heparin-induced 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