PMID- 27106479
OWN - NLM
STAT- MEDLINE
DCOM- 20170313
LR  - 20220321
IS  - 1865-3774 (Electronic)
IS  - 0925-5710 (Linking)
VI  - 104
IP  - 1
DP  - 2016 Jul
TI  - Screening frequency, incidence and pattern of heparin-induced thrombocytopenia 
      syndrome at a large tertiary institution.
PG  - 92-8
LID - 10.1007/s12185-016-2013-3 [doi]
AB  - Increasing awareness and availability of tests for anti-PF4/heparin complex 
      antibodies has raised concerns about indiscriminate testing and inappropriate 
      diagnosis of heparin-induced thrombocytopenia. A retrospective review of HITS 
      testing at a large tertiary centre was performed to determine test patterns and 
      incidence of HITS. Records of anti-PF4 tests over 4 years were reviewed. Positive 
      results were matched against patient medical records and records of heparin 
      utilisation for the diagnosis of HITS. Total of 33,308 patients (9.89 % of 
      admissions) were exposed to at least 1 day of unfractionated heparin (UFH) or low 
      molecular weight heparin (LMWH). Of 346 anti-PF4 antibody assays performed, 52 
      (15 %) were positive. Seventeen patients (4.9 % of total) were determined to have 
      HITS. Of these, 13 cases (76 %) were patients who were initiated on haemodialysis 
      via central venous catheters. Five patients (29 %) subsequently experienced 
      thrombosis. The rate of HITS in patients given UFH was 0.33 %. HITS occurred in 
      only one patient given LMWH. Of 1337 patients with chronic renal failure 
      initiated on long term haemodialysis, the incidence of HITS was 0.97 %. Despite 
      increased awareness of HITS, testing frequency remains conservative. An 
      overwhelming majority of HITS cases were diagnosed among patients initiated on 
      haemodialysis.
FAU - Mya, Hae Tha
AU  - Mya HT
AD  - Department of Haematology, Singapore General Hospital, 20 College Road, 
      Singapore, 169856, Singapore. mya.hae.tha@singhealth.com.sg.
FAU - Tay, Hui Ming
AU  - Tay HM
AD  - Department of Haematology, Singapore General Hospital, 20 College Road, 
      Singapore, 169856, Singapore.
FAU - Gan, Shien Wen
AU  - Gan SW
AD  - Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
FAU - Surendran, Shilpa
AU  - Surendran S
AD  - Department of Haematology, Singapore General Hospital, 20 College Road, 
      Singapore, 169856, Singapore.
FAU - Yeang, Shu Hui
AU  - Yeang SH
AD  - Department of Pharmacy, Singapore General Hospital, Singapore, Singapore.
FAU - Lim, Cynthia Ciwei
AU  - Lim CC
AD  - Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
FAU - Choong, HuiLin
AU  - Choong H
AD  - Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
FAU - Lee, Lai Heng
AU  - Lee LH
AD  - Department of Haematology, Singapore General Hospital, 20 College Road, 
      Singapore, 169856, Singapore.
FAU - Ng, Heng Joo
AU  - Ng HJ
AD  - Department of Haematology, Singapore General Hospital, 20 College Road, 
      Singapore, 169856, Singapore.
LA  - eng
PT  - Journal Article
DEP - 20160422
PL  - Japan
TA  - Int J Hematol
JT  - International journal of hematology
JID - 9111627
RN  - 0 (Antibodies)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Antibodies/analysis
MH  - Heparin/*adverse effects
MH  - Heparin, Low-Molecular-Weight/adverse effects
MH  - Humans
MH  - Incidence
MH  - Medical Records
MH  - Platelet Factor 4/immunology
MH  - Renal Dialysis/adverse effects
MH  - Retrospective Studies
MH  - Tertiary Care Centers
MH  - Thrombocytopenia/chemically induced/diagnosis/*etiology
OTO - NOTNLM
OT  - Heparin
OT  - Heparin-induced thrombocytopenia
OT  - Incidence
EDAT- 2016/04/24 06:00
MHDA- 2017/03/14 06:00
CRDT- 2016/04/24 06:00
PHST- 2016/01/20 00:00 [received]
PHST- 2016/03/08 00:00 [accepted]
PHST- 2016/03/08 00:00 [revised]
PHST- 2016/04/24 06:00 [entrez]
PHST- 2016/04/24 06:00 [pubmed]
PHST- 2017/03/14 06:00 [medline]
AID - 10.1007/s12185-016-2013-3 [pii]
AID - 10.1007/s12185-016-2013-3 [doi]
PST - ppublish
SO  - Int J Hematol. 2016 Jul;104(1):92-8. doi: 10.1007/s12185-016-2013-3. Epub 2016 
      Apr 22.