At Mayo Clinic Laboratories, where teamwork powers innovation, a cross-laboratory collaboration has enabled implementation of a cutting-edge, gold standard test for a life-threatening condition known as HIT, or heparin-induced thrombocytopenia.
The test, a serotonin release assay (SRA), uses the expertise and technologies of the Special Coagulation Laboratory (SCL) and Clinical Mass Spectrometry Laboratory (CMSL) to guide physicians on making an accurate diagnosis of HIT, which is an important first step in choosing the best blood thinner for their patients.
“The only way we can be successful and stand out as an organization is the collaborative approach for the common good of the patient,” says Mayo Clinic hematologist Rajiv K. Pruthi, M.B.B.S, professor of medicine and co-director of the SCL.
Available in only a few other reference laboratories across the country, the functional SRA (Mayo ID: SRAU) ties together decades of Mayo Clinic experience in clinical hematology and hematopathology with the expertise and advanced testing capabilities of mass spectrometry. The test provides clear answers on whether patients are at risk for developing HIT, which claims the lives of nearly 10% of those who develop the condition.
Confronting a deadly disease
Since going live in mid-June, Mayo Clinic Laboratories’ SRA is on track to be ordered nearly 3,000 times annually. The popularity of the assay reflects the need for testing amongst providers when faced with the weighty decision of continuing heparin treatment in patients presenting with signs and symptoms consistent with HIT, says Anand Padmanabhan, M.B.B.S., Ph.D., associate professor and senior associate consultant in the Divisions of Hematopathology and Transfusion Medicine.
Each year millions of patients receive the blood thinner heparin for a variety of reasons, including blood clot prevention and treatment. However, more than 1% of individuals exposed to the blood thinner develop the harmful immune response.2
In those cases, the anticoagulant triggers an antibody-mediated process that activates platelets, causing patients to become hypercoagulable and at risk for life-threatening blot clots.
“It’s a disease called paradoxical thrombosis,” Dr. Padmanabhan says. “Patients may develop clotting in many parts of the body. In the legs, for example, it can lead to amputations of the toes or the entire lower part of the leg. If it occurs in other sites, like the brain, you could have a stroke. There’s a lot of morbidity associated with this diagnosis — every day, five patients die due to HIT in the U.S. alone.”
“Early recognition of HIT is extremely important,” says Dr. Padmanabhan. “The risk of a delayed diagnosis can result in a high patient mortality.”
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