Abstract
In the United States, the most commonly employed screening assay for heparininduced thrombocytopenia (HIT) is the PF4 ELISA, of which both polyclonal (poly-ELISA) and IgG-specific (IgG-ELISA) assays are commercially available. We compared the IgG-ELISA versus the poly-ELISA to determine whether the IgGELISA is more sensitive and specific for the diagnosis of HIT. 453 HIT work-ups were reviewed. Patients with poly-ELISA optical density (OD) values greater than or equal to 0.40 (n=49) were selected for further analysis, including serotoninrelease assays (SRAs), IgG-ELISAs, and pre-test probability scoring (4T’s score). Both the poly-ELISA and IgG-ELISA identified PF4/heparin antibodies in all true HIT patients (n=8). IgG-ELISA reduced the number of “borderline” cases by 75%. IgG-ELISA is more specific than poly-ELISA and can reduce number of confirmatory SRA required.
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