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Anand Padmanabhan: Negative ELISA Does Not Rule Out Heparin-Induced Thrombocytopenia
Anand Padmanabhan/LinkedIn
May 4, 2026, 12:21

Anand Padmanabhan: Negative ELISA Does Not Rule Out Heparin-Induced Thrombocytopenia

Anand Padmanabhan, Professor and Clinician-Investigator at Mayo Clinic, shared on LinkedIn about a recent article he and his colleagues co-authored, published in American Journal of Hematology, adding:

” New publication in American Journal of Hematology from our group:

Discusses an under-recognized entity, ‘ELISA-negative HIT’ – Patients with pathogenic, platelet-activating anti-PF4 antibodies despite negative HIT ELISA tests

  • In a cohort of 500 cases, found missed diagnoses (3/500 ~0.6%) that most standard ELISA assays (with PF4/polyvinyl sulfonate and PF4/Heparin targets) fail to detect
  • Clinical impact: Re-exposure to heparin led to platelet drops in all patients ELISA-neg HIT patients and new thrombosis in one
  • Takeaway: In infrequent settings, Negative ELISA does not rule-out HIT – functional testing plus clinical judgment remain critical

Congrats to the multi-center team who worked on this study: Adam Kanack, Leben Tefera, Emily Armstrong, Morayma Reyes, Kristi Smock, Ana Casanegra, Curtis Jones, Gretchen Johns, Demin Wang, Renren Wen, Dong Chen, Rajiv Pruthi.”

Title: Pathogenic PF4/Polyanion ELISA-Negative Antibodies in HIT

Authors: Adam J. Kanack, Noah P. Splinter, Emily E. Mauch, Leben Tefera, Morayma Reyes Gil, Sakshi Jasra, Andrew Goodwin, Kristi J. Smock, Hadiyah Ahmad, Aneel Ashrani, Nathaniel L. Robinson, Ana I. Casanegra, Curtis G. Jones, Shannon M. Pechauer, Erin Yttre, Richard H. Aster, Mindy C. Kohlhagen, Rachel R. Leger, Gretchen Johns, David L. Murray, Lu Zhou, Demin Wang, Renren Wen, Dong Chen, Rajiv K. Pruthi, Anand Padmanabhan

Anand Padmanabhan: Negative ELISA Does Not Rule Out Heparin-Induced Thrombocytopenia

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Adam J. Kanack American Journal of Hematology Ana I. Casanegra Anand Padmanabhan Andrew Goodwin Aneel Ashrani Curtis G. Jones David L. Murray Demin Wang Dong Chen ELISA Emily E. Mauch Erin Yttre Gretchen Johns Hadiyah Ahmad Health Hematology Hemostasis Hemostasis News Hemostasis Today Heparin HIT Kristi J Smock Leben Tefera Lu Zhou Medicine Mindy C. Kohlhagen Morayma Reyes Gil Nathaniel L. Robinson Noah P. Splinter PF4 Rachel R. Leger Rajiv K. Pruthi Renren Wen Richard H. Aster Sakshi Jasra Shannon M. Pechauer thrombosis
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