2024 Volume 73 Issue 4 Pages 684-690
Heparin-induced thrombocytopenia (HIT) is a serious adverse reaction associated with heparin use. While rapid antibody testing is crucial, it’s mainly outsourced. In our hospital, we have been performing in-house testing using the ELISA method. However, the procedure has been cumbersome and results took several hours to be reported. Recently, an immunochromatographic (IC) assay with a response time of 15 minutes was developed and became eligible for insurance coverage from May of the 5th year of Reiwa era. Therefore, we conducted an assessment of its utility. The concordance rate was 86%, indicating good results. Analysis of discordant cases and cases allowing longitudinal evaluation revealed factors such as differences in specificity due to variations in measurement principles and antigen usage, as well as differences in sensitivity. Furthermore, a positive result for HIT antibodies through immunological measurements does not necessarily indicate the onset of HIT. Diagnosing HIT based solely on HIT antibody positivity may lead to overdiagnosis. However, the functionally-based measurement methods, considered the gold standard in Europe and the United States, are challenging to implement outside of research facilities. Therefore, diagnosing HIT requires a combination of serological and clinical findings for confirmation. This study demonstrated that HIT antibody testing, which previously required significant time, can now be determined and reported within 15 minutes, facilitating easy retesting in accordance with symptom improvements. This is expected to contribute to the rapid diagnosis and appropriate management of HIT.
