[Heparin induced autoimmune thrombocytopenia: assessment of a rapid functional assay]

Heparin-induced thrombocytopenia (HIT) diagnosis is often difficult. Depending on the patients, the thrombocytopenia could be due to various causes. Despite their poor sensitivity and specificity, biological tests are necessary to clarify the diagnosis. In 1985, a new heparin-induced platelet aggregation assay was described that consists in determining the percentage of aggregated platelets by using an automated cell counter. Plasma samples from 18 patients with a definite HIT were tested with this quick easy-to-perform HIT diagnosis test. Positive results were obtained with 11 plasma (61%) when the test was performed with platelets from 3 different healthy volunteers (control platelets). As for the other functional tests, results are depending on control platelets and sensitivity seems to be increased when control platelets FcgammaRIIa-131 polymorphism was of His/His (but difference is not significant). In emergency situation, it is difficult to perform a functional test with control platelets from several healthy donors, and it is even more difficult to select volunteers on their FcgammaRIIa-131 polymorphism. In conclusion, in spite of its practicability, the test is not reliable to help in the rapid diagnosis of HIT. Indeed, 7 patients of 18 (39%) with definite HIT have been found negative with this test.