Sakata Toshiyuki
I.L. Japan Co., Ltd., Minato-ku, Tokyo 108-0023, Japan.
Rinsho Byori. 2013 Feb;61(2):137-43.
Heparin-induced thrombocytopenia (HIT) is a 'clinicopathologic syndrome'; therefore, its diagnosis depends on clinical criteria including the presence of thrombocytopenia and/or thrombosis and a pathological criterion implying the detectability of HIT antibodies. Recently, medical reimbursement (390 points) for assays of HIT antibodies using three new assay kits [HemosIL HIT-Ab(PF4-H), HemosIL AcuStar HIT IgG(PF4-H), HemosIL AcuStar HIT-Ab(PF4-H)] was approved in Japan. The HemosIL HIT-Ab(PF4-H) kit is a latex particle-enhanced immunoturbidimetric assay to detect total heparin-associated antibodies found in HIT patients. A monoclonal antibody that mimics human HIT antibodies is coated onto latex particles. HemosIL AcuStar HIT-IgG(PF4-H) (specific for IgG anti-PF4/heparin antibodies) and HemosIL AcuStar HIT Ab(PF4-H) (detecting IgG, IgM and IgA anti-PF4/heparin antibodies) are applicable to a fully automated quantitative chemiluminescent immnunoassay instrument 'ACL AcuStar'. HIT can be excluded in all patients by a negative antigen assay using HemosIL HIT-Ab(PF4-H) or HemosIL AcuStar HIT-Ab(PF4-H). Furthermore, in patients with previous HIT who require heparin treatment, pretesting by HemosIL HIT-Ab(PF4-H) or HemosIL AcuStar HIT-Ab(PF4-H) might be useful for preventing the onset of rapid-type HIT.
肝素诱导的血小板减少症(HIT)是一种“临床病理综合征”;因此,其诊断取决于临床标准,包括血小板减少和/或血栓形成的存在,以及一项暗示可检测到HIT抗体的病理标准。最近,日本批准了使用三种新检测试剂盒[HemosIL HIT-Ab(PF4-H)、HemosIL AcuStar HIT IgG(PF4-H)、HemosIL AcuStar HIT-Ab(PF4-H)]检测HIT抗体的医疗报销(390分)。HemosIL HIT-Ab(PF4-H)试剂盒是一种乳胶颗粒增强免疫比浊法,用于检测HIT患者中发现的总肝素相关抗体。一种模拟人类HIT抗体的单克隆抗体包被在乳胶颗粒上。HemosIL AcuStar HIT-IgG(PF4-H)(特异性针对IgG抗PF4/肝素抗体)和HemosIL AcuStar HIT Ab(PF4-H)(检测IgG、IgM和IgA抗PF4/肝素抗体)适用于全自动定量化学发光免疫分析仪器“ACL AcuStar”。使用HemosIL HIT-Ab(PF4-H)或HemosIL AcuStar HIT-Ab(PF4-H)进行阴性抗原检测可排除所有患者的HIT。此外,对于先前患有HIT且需要肝素治疗的患者,使用HemosIL HIT-Ab(PF4-H)或HemosIL AcuStar HIT-Ab(PF4-H)进行预测试可能有助于预防快速型HIT的发生。