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False-Negative Platelet Factor 4 Antibodies and Serotonin Release Assay and the Utility of Repeat Testing in the Diagnosis of Heparin-Induced Thrombocytopenia and Thrombosis.
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False-Negative Platelet Factor 4 Antibodies and Serotonin Release Assay and the Utility of Repeat Testing in the Diagnosis of Heparin-Induced Thrombocytopenia and Thrombosis.

- November 15, 2021 | November 3, 2022 - Mitchell
To report a case of false-negative serological assessments within the analysis of heparin-induced thrombocytopenia (HIT) adopted by a quick evaluation of the literature on this matter.A 75-year-old Caucasian feminine affected person was admitted with a traumatic proper ankle fracture that required open discount and inside fixation.
Regardless of postoperative subcutaneous heparin chemoprophylaxis, she developed deep vein thrombosis (DVT) and pulmonary embolism (PE) on day four and subsequently began on steady heparin infusion. On day 5, she suffered a stroke from an entire occlusion of the precise widespread carotid artery with tandem occlusion of the precise center cerebral artery. She underwent profitable thrombectomy of each arteries. The proposed stroke mechanism was paradoxical embolism by way of a patent foramen ovale.
Over the following few days, thrombocytopenia was famous, the heparin drip was stopped, and HIT antibodies (antibodies focusing on the complicated of platelet issue four and heparin; PF4-H AB) and serotonin launch assay (SRA) assessments had been despatched. Due to the suspicion for HIT, she was began on bivalirudin with subsequent enchancment in platelet depend.
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Preliminary PF4-H AB and SRA assessments had been adverse, bivalirudin was stopped, and heparin was restarted. Subsequently, her platelets trended down, once more elevating scientific suspicion of HIT. Repeat PF4-H AB and SRA testing resulted optimistic.A optimistic SRA within the acceptable context is taken into account for the analysis of heparin-induced thrombocytopenia.
This case report highlights that false-negative serological analysis is feasible early in the middle of the illness. Repeat testing is really helpful in sufferers with excessive scientific suspicion.

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