{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:20:51Z","timestamp":1789402851747,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated the clinical characteristics and treatment outcomes of heparin\u2010induced thrombocytopenia (HIT) following therapeutic plasma exchange (TPE) with heparin anticoagulation in patients with neurological autoimmune diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data were prospectively collected from 158 patients (79 males, 79 females; mean age 37.49\u2009\u00b1\u200916.95\u2009years) with neurological autoimmune diseases who underwent TPE in the neuro\u2010intensive care unit between January 2016 and June 2024. For patients with continuous platelet decline after TPE, the 4Ts score was determined, and platelet factor 4 (PF4) antibody tests were performed. Their platelet counts, clinical complications (thrombosis and bleeding), treatment plans, outcomes, and prognoses before and after TPE were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred thirty\u2010nine patients experienced at least one significant decrease in platelet count during TPE (average decrease 36.75\u2009\u00b1\u200919.63%), and the average 4Ts score was 3.55\u2009\u00b1\u20091.87 points. PF4 antibody testing was conducted on 23 patients with continuous platelet decline and 4Ts scores \u2265\u20094. Four PF4\u2010positive patients were diagnosed with type II HIT and developed deep vein thrombosis. After heparin withdrawal, the platelet count gradually normalized after intravenous immunoglobulin (IVIG), nonheparin TPE, or argatroban\/fondaparinux anticoagulant therapy (mean recovery time 8.17\u2009\u00b1\u20093.54\u2009days). The platelet counts spontaneously recovered for the remaining 116 patients (mean recovery time 3.88\u2009\u00b1\u20092.66\u2009days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Platelet counts should be dynamically monitored throughout TPE with heparin anticoagulation. Patients with continually decreasing platelet counts and an intermediate to high 4Ts score should be monitored for HIT. Heparin should be discontinued immediately for patients with type II HIT, and nonheparin anticoagulants, IVIG, or nonheparin TPE may be administered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sdi.13259","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T02:30:01Z","timestamp":1748313001000},"page":"267-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Analysis of Heparin\u2010Induced Thrombocytopenia due to Therapeutic Plasmapheresis With Heparin Anticoagulation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7391-5867","authenticated-orcid":false,"given":"Chenling","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Department of Neurology Tongde Hosiptal of Zhejiang Province  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongtao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"},{"name":"Department of Neurology Chongqing Hechuan District People's Hospital  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology Xuanwu Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X19898253"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12059"},{"issue":"06","key":"e_1_2_9_5_1","first-page":"408","article-title":"Chinese Expert Consensus on Heparin\u2010Induced Thrombocytopenia (2017)","volume":"98","author":"Professional Committee on Thrombosis Prevention and Control of Cardiovascular Medicine Branch of Chinese Medical Doctor Association","year":"2018","journal-title":"Zhonghua Medical Journal"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-04-1546"},{"key":"e_1_2_9_7_1","unstructured":"National Health Commission of China.Standard Operating Procedure for Plasma Exchange. Published2021."},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(18)30046-2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00756-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.05.024"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2013.07.021"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00457-9"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096\u2010021\u201001260\u2010z"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102014\u201007\u2010590844"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16018"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2020.04.029"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.51.7106"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21876"}],"container-title":["Seminars in Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.13259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T02:21:04Z","timestamp":1756174864000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sdi.13259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/sdi.13259"],"URL":"https:\/\/doi.org\/10.1111\/sdi.13259","archive":["Portico"],"relation":{},"ISSN":["0894-0959","1525-139X"],"issn-type":[{"value":"0894-0959","type":"print"},{"value":"1525-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,26]]},"assertion":[{"value":"2025-01-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}