Biologie des anomalies de l’hémostase. - Brief INAHTA - Biology of haemostasis disorders: photometric platelet aggregation test

Has

Description

Mis en ligne le 20 juil. 2011 Ce travail a eu pour but d’évaluer dix actes de biologie mesurant les anomalies de l’hémostase, qui avaient été signalés par le demandeur de cette évaluation soit comme obsolètes mais figurant encore à la Nomenclature des actes de biologie médicale (NABM), soit comme pertinents mais ne figurant pourtant pas dans cette nomenclature.Cette évaluation pourra donc permettre l’actualisation du sous chapitre 5-02 « Hémostase et coagulation » de la NABM. Cette évaluation a donné lieu à la rédaction de sept documents :Tome I : Evaluation du Temps de saignement (Epreuve de DUKE et tests d’IVY) ;Tome II : Temps de Thrombine et correction du Temps de Thrombine ;Tome III : Test photométrique d’agrégation plaquettaire ;Tome IV : Recherche d’anticorps antifacteur 4 plaquettaire dans le cadre d’une thrombopénie induite par l’héparine ;Tome V : Recherche et titrage d’inhibiteur contre les facteurs antihémophiliques ;Tome VI : Détection d’un anticoagulant de type lupique ;Tome VII : Recherche de la mutation G1691A du gène du facteur V (FV de Leiden) et de la mutation G20210A du gène du facteur II. Le texte court de cette évaluation reprend la totalité des 7 tomes (10 actes évalués). Mis en ligne le 20 juil. 2011

Sujets

• Biologie
• Médecine

Informations

• Publié par: haute-autorite-sante-techniques-et-procedures-de-diagnostic
• Publié le: 01 juillet 2011
• Nombre de lectures: 9
• Licence : En savoir +
  Paternité, pas d'utilisation commerciale, partage des conditions initiales à l'identique
• Langue: Français

Extrait

 

INAHTA brief   Titleof haemostasis disorders: photometric platelet aggregation test  Biology   Agency French National Authority for Health (Haute Autorité de Santé) HAS,    2 avenue du Stade de France – F 93218 La Plaine Cedex, France  Tel: + 33 (0) 1 55 93 71 13 – Fax: + 33 (0) 1 55 93 74 35    apset.acntcorétf.s-nah@sa,.franteas-sww.hw    Referencetaor/pfrs/cm/jil899001_coib/rf/2ttp:h.wah//wwtn.e-saslogie-des-anomalei-sed- lhemostase      Aim The National Salaried Workers’ Health Insurance Fund (CNAMTS) asked HAS to assess the value of the different laboratory tests for haemostasis abnormalities with a view to updating the section in the Nomenclature of Procedures in Laboratory Medicine (NABM) containing the procedures in laboratory medicine for measuring abnormalities of haemostasis (subsection 5-02). One of those tests is the photometric platelet aggregation test (PAT), which is not an NABM procedure. The PAT is regarded as the reference test for the assessment of platelet function, for which it is still the most used test. This technique measures aggregation in platelet-rich plasma (PRP) obtained after low-speed centrifugation of a sample of the patient’s blood collected in sodium citrate. Aggregation is measured by a photometric technique after the addition of various inducers, also called aggregating agents or agonists. Since the preanalytical and analytical requirements are relatively demanding (for example blood sampling conditions, storage of the sample, time for carrying out the examination, preparation of platelet-rich and platelet-poor plasmas, centrifugation conditions, etc.), the photometric platelet aggregation test would need to be carried out at experienced centres that are sufficiently busy to maintain expertise in using the technique and interpreting the results.     Conclusions and results According to the different documents analysed, the photometric platelet aggregation test is recommended:  - for the diagnosis of haemorrhagic disorders; - for the diagnosis of heparin-induced thrombocytopenia (HIT), combined with an immunological test, in the following cases: – a relative drop in platelets, in two successive counts, of 30 % to 50 %, during treatment with heparin and/or a platelet count of < 100 to 150 G/L in the absence of any earlier count; - venous or arterial thrombosis during treatment with heparin; - thrombosis or thrombocytopenia, even if the patient has been off heparin for a few days; - resistance to heparin therapy with spread of the thrombotic process. On the other hand, on the basis of the different documents analysed, testing for resistance to antiplatelet drugs, whatever the method used, and thus including the photometric platelet aggregation test, is at present not recommended for routine individual use.   Recommendations    In conclusion, on the basis of the literature identified and analysed, the photometric platelet aggregation test is recommended for the diagnosis of platelet function abnormalities, and for the laboratory diagnosis of HIT. Since the preanalytical and analytical requirements were relatively demanding, the photometric platelet aggregation test needs to be carried out at

2 Avenue du Stade de France – 93218 Saint-Denis La Plaine CEDEX, France Tel.: [phone] – Fax: [phone] –[e-mail]