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Platelet factor 4/heparin antibody (IgG/M/A) in healthy subjects: a literature analysis of commercial immunoassay results

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Abstract

Purpose We determined the seroprevalence of platelet factor 4 (PF4)/heparin antibodies in healthy subjects. Methods A literature search identified studies in which healthy subjects were evaluated using commercial immunoassays for PF4/heparin antibody (IgG/M/A). Proportions of test-positive subjects were calculated, by assay. Results Across 11 eligible studies, 860 healthy subjects were tested using the Stago enzyme-linked immunosorbent assay (ELISA) (nine studies), GTI ELISA (three studies), and/or DiaMed particle gel immunoassay (PGIA) (three studies). Seropositivity occurred in 17 of 790 (2.2%, 95% CI, 1.1–3.2%) subjects by Stago ELISA, one of 100 (1.0%, 95% CI, 0–3.0%) subjects by GTI ELISA, and three of 70 (4.3%, 95% CI, 0–9.0%) subjects by PGIA (P > 0.20). Of seven seropositive subjects tested further, none had platelet-activating antibodies. Conclusion Commercial immunoassays detect PF4/heparin antibody in 1.0–4.3% of healthy subjects. Because this “background” prevalence overlaps seropositivity rates in heparin-treated patients in various clinical settings, normality cut-offs may require refinement.

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Acknowledgments

The authors have full control of all primary data and agree to allow the journal to review their data if requested. Supported by the National Institutes of Health HL081395 (GMA).

Disclosure

GMA has received research support from Amgen, GlaxoSmithKline, and Progen Industries; Marcie J. Hursting has received consultancy fees from GlaxoSmithKline.

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Correspondence to Gowthami M. Arepally.

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Frederick Spencer, MD served as the guest editor for the manuscript.

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Arepally, G.M., Hursting, M.J. Platelet factor 4/heparin antibody (IgG/M/A) in healthy subjects: a literature analysis of commercial immunoassay results. J Thromb Thrombolysis 26, 55–61 (2008). https://doi.org/10.1007/s11239-008-0217-y

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  • DOI: https://doi.org/10.1007/s11239-008-0217-y

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