PMID- 16175007
OWN - NLM
STAT- MEDLINE
DCOM- 20060223
LR  - 20190917
IS  - 0957-5235 (Print)
IS  - 0957-5235 (Linking)
VI  - 16
IP  - 7
DP  - 2005 Oct
TI  - Functional characterization of antibodies against heparin-platelet factor 4 
      complex in heparin-induced thrombocytopenia patients in Asian-Indians: relevance 
      to inflammatory markers.
PG  - 487-90
AB  - Occurrence of heparin-induced thrombocytopenia (HIT) was investigated for 33 
      Indian patients undergoing cardiovascular surgery who received unfractionated 
      heparin (UFH). Platelet counts were performed prior to the initiation of UFH 
      therapy and 5-16 days post therapy. Heparin-induced platelet aggregation, 
      C-serotonin release assay, and enzyme-linked immmunosorbent assay (ELISA) tests 
      were performed in all the patients to detect the antibodies formed against the 
      complex of heparin and platelet factor 4 (HPF4). Levels of inflammatory 
      markers/mediators such as CD40 ligand (CD40L) and C-reactive protein (CRP) were 
      also measured in the patient plasmas utilizing ELISA tests. Based on clinical 
      observations and laboratory diagnoses, five patients (15%) were considered to 
      have confirmed HIT. Despite wide variations in the titers of inflammatory 
      markers, patients who tested ELISA-positive for HPF4 antibodies showed markedly 
      elevated levels of both soluble CD40L and C-reactive protein. Most strikingly, 
      the C-serotonin release assay-positive patients showed up to a 10-fold increase 
      in the level of CD40L. It is concluded that approximately 15% Asian-Indian 
      patients receiving UFH during cardiovascular surgery develop functional HPF4 
      antibodies, which are associated with the increased levels of inflammatory 
      markers/mediators in this catastrophic HIT syndrome.
FAU - Kannan, Meganathan
AU  - Kannan M
AD  - All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
FAU - Ahmad, Sarfraz
AU  - Ahmad S
FAU - Ahmad, Firdos
AU  - Ahmad F
FAU - Kale, Shailaja
AU  - Kale S
FAU - Hoppensteadt, Debra A
AU  - Hoppensteadt DA
FAU - Fareed, Jawed
AU  - Fareed J
FAU - Saxena, Renu
AU  - Saxena R
LA  - eng
PT  - Journal Article
PL  - England
TA  - Blood Coagul Fibrinolysis
JT  - Blood coagulation & fibrinolysis : an international journal in haemostasis and 
      thrombosis
JID - 9102551
RN  - 0 (Antibodies)
RN  - 0 (Anticoagulants)
RN  - 0 (Biomarkers)
RN  - 147205-72-9 (CD40 Ligand)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibodies/*blood/immunology
MH  - Anticoagulants/adverse effects/immunology
MH  - Biomarkers/blood
MH  - C-Reactive Protein/metabolism
MH  - CD40 Ligand/blood
MH  - Child
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Heparin/*adverse effects/*immunology
MH  - Humans
MH  - India
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation/drug effects
MH  - Platelet Factor 4/*immunology
MH  - Thrombocytopenia/blood/*chemically induced/diagnosis/*immunology
EDAT- 2005/09/22 09:00
MHDA- 2006/02/24 09:00
CRDT- 2005/09/22 09:00
PHST- 2005/09/22 09:00 [pubmed]
PHST- 2006/02/24 09:00 [medline]
PHST- 2005/09/22 09:00 [entrez]
AID - 00001721-200510000-00005 [pii]
AID - 10.1097/01.mbc.0000178829.31902.0a [doi]
PST - ppublish
SO  - Blood Coagul Fibrinolysis. 2005 Oct;16(7):487-90. doi: 
      10.1097/01.mbc.0000178829.31902.0a.