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Increased prevalence of Anti‐Heparin Platelet factor 4 antibodies in patients with sepsis associated Disseminated Intravascular Coagulation

The purpose of this investigation was to study the prevalence of anti‐ HPF4 antibodies in patients with sepsis associated DIC. A total of 727 baseline blood samples were obtained from patients recruited in the ART‐123 trial, which was designed to test the therapeutic efficacy of recombinant thrombomodulin in this indication. A sandwich based ELISA method (GTI, Waukesha, WI) was used to detect anti‐HPF4 antibodies. In this multicentric study, patient plasma was received at Loyola University Medical Center in frozen form and analyzed in batches. Of the 727 samples, 173 (23.8%) were found to be positive for the presence of anti‐HPF4 antibody (using the cut off criteria of OD>0.4, mean OD=0.653, SEM=0.032). 554 patients (76.2%) were found to be negative in accordance to the criterion (OD<0.4, mean OD=0.254, SEM=0.005). The absorbance ranges were then analyzed in four quartiles for the entire study cohort. There were 280 patients (38.5%) that fell in the first quartile (OD<0.25), 350 patients (48.1%) in the 2nd quartile (OD 0.25–0.50), 60 patients (8.2%) in the 3rd quartile and 37 patients (5.1%) in the 4th quartile. These observations clearly suggest that a significant number of these patients exhibit a high titer of the anti‐HPF4 antibody.