{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:36:18Z","timestamp":1793723778661,"version":"4.6.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Heparin\u2010induced thrombocytopenia (HIT) is a rare but potentially life\u2010threatening, immune\u2010mediated adverse reaction to heparin. PF4\u2010dependent immunoassays are sensitive screening tests, but they detect both platelet\u2010activating and nonactivating antibodies; therefore, positive results require interpretation in clinical context and, when available, confirmation with a functional platelet activation assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared dilution endpoints of an in\u2010house flow cytometric platelet activation assay with an IgG\u2010specific PF4\/polyanion ELISA and a PF4\u2010dependent lateral flow immunoassay (LFA). Six consecutive ELISA\u2010positive patient sera and one external ELISA\u2010positive control serum were tested neat and in serial twofold dilutions (up to 1:2048) in parallel with all three methods. Platelet activation was assessed using platelet\u2010rich plasma from four healthy donors in the presence of low and high doses of heparin and quantified by CD62P expression on CD61\u2010positive platelets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five patient sera and the external control showed heparin\u2010dependent platelet activation, whereas one ELISA\u2010positive serum was nonactivating. All three assays were concordantly positive through dilutions up to 1:32 in platelet\u2010activating samples. At higher dilutions, the LFA remained positive more often than the ELISA or the flow cytometric assay. Across 72 dilution points from platelet\u2010activating sera and the external control, the ELISA was positive in 47\/72, the flow assay in 51\/72, and the LFA in 67\/72. In several sera, mild dilution increased the ELISA signal and\/or platelet activation, consistent with a prozone\u2010like stoichiometric effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this pilot dilution\u2010series study, the in\u2010house flow cytometric assay showed dilution endpoints broadly comparable to the IgG\u2010specific ELISA for platelet\u2010activating anti\u2010PF4\/heparin antibodies. The LFA remained positive at lower apparent antibody levels than either the ELISA or the functional assay, but also gave a positive result in the serum that did not contain platelet\u2010activating anti\u2010PF4\/heparin antibodies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70210","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:19:03Z","timestamp":1785201543000},"page":"1464-1471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dilution\u2010Endpoint Comparison of a Flow Cytometric Platelet Activation Assay With\n                    <scp>PF4<\/scp>\n                    \/Heparin\n                    <scp>ELISA<\/scp>\n                    and a Lateral Flow Immunoassay in Suspected\n                    <scp>HIT<\/scp>"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8312-1331","authenticated-orcid":false,"given":"Elvira","family":"Mali\u010dev","sequence":"first","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine  Ljubljana Slovenia"},{"name":"Biotechnical Faculty, University of Ljubljana  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matja\u017e","family":"Urbajs","sequence":"additional","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina Jazbec","family":"Gradi\u0161ar","sequence":"additional","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Kolenc","sequence":"additional","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine  Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6466-4039","authenticated-orcid":false,"given":"Primo\u017e","family":"Ro\u017eman","sequence":"additional","affiliation":[{"name":"Slovenian Institute for Transfusion Medicine  Ljubljana 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