Evaluation of STic Expert® HIT Kit and Its Comparison with ID-PaGIA™ Test in Suspected Heparin-Induced Thrombocytopenia

  • Narender KumarEmail author
  • Varun Uppal
  • Jasmina Ahluwalia
  • Pankaj Malhotra
  • Neelam Varma
  • Ashish Jain
Short Communication


Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction caused by heparin. HIT occurs due to IgG antibodies directed against heparin-bound platelet factor 4 (PF4). The aim of this study was to evaluate the STic® Expert HIT for detection of anti-PF4/heparin antibodies in comparison with ID-PaGIA™ kit. The results were further confirmed by Heparin-induced platelet aggregation test (HIPA). A total of 17 patients with a suspected diagnosis of HIT were enrolled. The 4 T scoring of each case was performed. Testing for HIT was carried out by ID-PaGIA™, STic® Expert HIT, and HIPA. Testing by STic® Expert HIT test demonstrated positivity in three cases while testing by ID-PaGIA™ test kit revealed four positive cases. Two of these cases were confirmed as HIT by HIPA. The study suggests that STic® Expert HIT an equally effective test, in combination with the 4T scoring system for detecting/excluding the diagnosis of HIT. A large number of cases are needed for validation.


ID-PaGIA™ Heparin-induced platelet aggregation Heparin-induced thrombocytopenia STic® Expert HIT 



This study was funded by ‘Institute Research grant’ No. 71/6-edu/13/1505 dated 13.06.2014 from Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Compliance with Ethical Standards

Conflict of interest

There is no conflict of interest amongst any of the authors.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Greinacher A, Warkentin TE (2006) Recognition, treatment, and prevention of heparin induced thrombocytopenia: review and update. Thromb Res 118:165–176CrossRefGoogle Scholar
  2. 2.
    Amiral J, Marfaing-Koka A, Poncz M, Meyer D (1998) The biological basis of heparin-induced thrombocytopenia. Platelets 9:77–91CrossRefGoogle Scholar
  3. 3.
    Rice L (2004) Heparin-induced thrombocytopenia: myths and misconceptions (that will cause trouble for you and your patient). Arch Intern Med 164:1961–1964CrossRefGoogle Scholar
  4. 4.
    Cummins D (1995) Which patients undergoing cardiopulmonary bypass should be assessed for development of heparin-induced thrombocytopenia? Thromb Haemost 73:890–895CrossRefGoogle Scholar
  5. 5.
    Crowther MA, Cook DJ, Albert M, Williamson D, Meade M, Granton J et al (2010) The 4Ts scoring system for heparin-induced thrombocytopenia in medical-surgical intensive care unit patients. J Crit Care 25:287–293CrossRefGoogle Scholar
  6. 6.
    Lo GK, Juhl D, Warkentin TE, Sigouin CS, Eichler P, Greinacher A (2006) Evaluation of pretest clinical score (4 T’s) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings. J Thromb Haemost 4:759–765CrossRefGoogle Scholar
  7. 7.
    Warkentin TE, Heddle NM (2003) Laboratory diagnosis of immune heparin-induced thrombocytopenia. Curr Hematol Rep 2:148–157Google Scholar
  8. 8.
    Meyer O, Salama A, Pittet N, Schwind P (1999) Rapid detection of heparin-induced platelet antibodies with particle gel immunoassay (ID-HPF4). Lancet 354:1525–1526CrossRefGoogle Scholar
  9. 9.
    Sachs UJ, von Hesberg J, Santoso S, Bein G, Bakchoul T (2011) Evaluation of a new nanoparticle-based lateral-flow immunoassay for the exclusion of heparin-induced thrombocytopenia (HIT). Thromb Haemost 106:1197–1202CrossRefGoogle Scholar
  10. 10.
    Laffan M, Manning R (2011) Laboratory control of anticoagulant, thrombolytic and antiplatelet therapy. In: Bain BJ, Bates I, Laffan MA, Lewis SM (eds) Dacie and Lewis practical haematology, 11th edn. Elsevier Churchill Livingstone, London, pp 476–477Google Scholar
  11. 11.
    Kapadia FN, Ketkar AS, Deshpande AS, Puri VC, Khodaiji SJ (2013) Evaluation of various laboratory assays in detection of heparin-induced thrombocytopenia in an adult general ICU. Int J Lab Hematol 35:137–143CrossRefGoogle Scholar
  12. 12.
    Kotwal J, Chaudhary S, Manoj MG, Hasnain S, Nair V, Luthra M (2014) Heparin induced thrombocytopenia: incidence and laboratory approach to diagnosis in Indians. Indian J Pathol Microbiol 57:31–38CrossRefGoogle Scholar
  13. 13.
    Sachan D, Gupta N, Agarwal P, Chaudhary R (2011) The utility of pre-test clinical scoring for clinical diagnosis of heparin-induced thrombocytopenia in cardiac surgery patients of a tertiary care centre in north India. Transfus Med 21:231–235CrossRefGoogle Scholar
  14. 14.
    Berroëta C, Crespin M, Bouabdallah K, Pargade S, Huchet FX, Bourel P et al (2016) DiagnoSTic® performance of a new rapid lateral flow immunoassay in patients suspected of heparin-induced thrombocytopenia and its clinical consequences. Semin Thromb Hemost 42:69–74CrossRefGoogle Scholar
  15. 15.
    Leroux D, Hezard N, Lebreton A, Bauters A, Suchon P, de Maistre E et al (2014) Prospective evaluation of a rapid nanoparticle-based lateral flow immunoassay (STic® Expert(®) HIT) for the diagnosis of heparin-induced thrombocytopenia. Br J Haematol 166:774–782CrossRefGoogle Scholar
  16. 16.
    Vianello F, Sambado L, Scarparo P, Lombardi A, Bernardi D, Plebani M et al (2015) Comparison of three different immunoassays in the diagnosis of heparin-induced thrombocytopenia. Clin Chem Lab Med 53:257–263CrossRefGoogle Scholar

Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  • Narender Kumar
    • 1
    Email author
  • Varun Uppal
    • 1
  • Jasmina Ahluwalia
    • 1
  • Pankaj Malhotra
    • 2
  • Neelam Varma
    • 1
  • Ashish Jain
    • 3
  1. 1.Department of Hematology, Level 5, Research Block APostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of Internal MedicinePostgraduate Institute of Medical Education and ResearchChandigarhIndia
  3. 3.Department of Transfusion MedicinePostgraduate Institute of Medical Education and ResearchChandigarhIndia

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