Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Hematology Am Soc Hematol Educ Program. 2009:250-2. doi: 10.1182/asheducation-2009.1.250.
You are asked to consult on a 76-year-old man admitted to the hospital with pneumonia and thrombocytopenia. Ten days before the current admission, he had undergone surgery to repair a small bowel obstruction. A preoperative platelet count had been normal. Following surgery, he received subcutaneous unfractionated heparin thromboprophylaxis until his discharge on post-operative day 5. In your differential diagnosis for the patient's thrombocytopenia, you consider heparin-induced thrombocytopenia (HIT) and wish to order laboratory testing. In addition to a polyspecific anti-PF4/heparin ELISA for the diagnosis of HIT, your laboratory has recently begun to offer an IgG-specific ELISA. You wonder which of these assays performs better in the diagnosis of HIT.
一位 76 岁的男性因肺炎和血小板减少症入院，现邀请你会诊。在本次入院前 10 天，他因小肠梗阻接受了手术治疗。术前血小板计数正常。手术后，他接受了皮下普通肝素预防血栓形成治疗，直到术后第 5 天出院。在考虑患者血小板减少症的鉴别诊断时，你考虑肝素诱导的血小板减少症（HIT），并希望进行实验室检测。除了用于诊断 HIT 的多特异性抗 PF4/肝素 ELISA 外，你的实验室最近还开始提供 IgG 特异性 ELISA。你想知道哪种检测方法在诊断 HIT 方面表现更好。
