Platelet & Neutrophil Immunology Laboratory

Strong History
The Platelet & Neutrophil Immunology Laboratory (PNIL), part of the Diagnostic Laboratories at BloodCenter of Wisconsin, is a global resource for diagnosing immune disorders. PNIL evaluates blood samples from patients with thrombocytopenia thought to be of immune origin. For more than 35 years, the laboratory has combined specialized testing and clinical expertise to bring you the best care for your patients.

PNIL at BloodCenter of Wisconsin was established in 1972 by Dr. Richard Aster, a pioneer in the field of platelet immunology. Since then, PNIL has offered testing and clinical consultation to physicians treating patients with drug-induced, autoimmune, and alloimmune conditions associated with thrombocytopenia or neutropenia. The PNIL is one of only a few laboratories of its kind providing unique, specialized assays.

Specialized Testing
Heparin-induced thrombocytopenia (HIT) is a serious immune-mediated complication of heparin therapy affecting 1-4% of patients receiving the drug for at least 5 to 7 days.

PNIL at BloodCenter of Wisconsin is one of only a few laboratories in the US that performs HIT testing by Serotonin Release Assay (SRA) on a clinical basis. PNIL has a long history of performing this testing, conducting and publishing research in this area, and providing expert consultation on HIT test results.

Sensitive and specific laboratory tests can reliably confirm the diagnosis in patients with clinical findings of HIT after heparin exposure. The PF4 ELISA-IgG, performed at PNIL, is an example of a highly sensitive immunoassay that detects IgG HIT antibodies. The PF4 ELISA-IgM and PF4 ELISA-IgA are also performed to detect the occasional important non-IgG HIT antibody.

HIT tests have been evaluated for their utility in detecting antibodies in patients whose clinical courses suggest HIT. PNIL at BloodCenter of Wisconsin has concluded that the sensitivity, specificity, and related positive predictive value of both the functional and immunological tests for HIT are high when these assays are used to confirm the diagnosis in patients whose clinical findings are consistent with the syndrome.

In addition to being useful in confirming the initial diagnosis of HIT, testing for heparin-dependent antibodies can assist in the clinical management of patients previously diagnosed with the syndrome and for whom future exposures to heparin are anticipated.

PNIL at BloodCenter of Wisconsin also specializes in Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) as well as drug-dependent platelet antibodies, including those induced by quinine, abciximab (ReoPro^TM), Integrelin^TM, Aggrastat^TM, vancomycin (and other antibiotics), and "sulfa” drugs.

In addition, PNIL performs platelet antigen and antibody testing, neutrophil antibody testing and antigen typing for Transfusion-Related Acute Lung Injury (TRALI) and autoimmune neutropenia. The lab also performs immunophenotpying of red cells and white cells for expression of protein markers to aid in the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH), and for expression of GPIIb/IIIa and GPIb/IX on platelets for diagnosis of Glanzmann Thrombasthenia and Bernard Soulier Syndrome, respectively.

Clinical Expertise
Led by Jan McFarland, MD, and Brian Curtis, PhD, the PNIL team provides consultation regarding differential diagnosis and will help you evaluate the test results. Dr. Curtis and Dr. McFarland are readily accessible by phone or email to assist in the use of PNIL testing results for patient diagnosis and management.

Key Contacts
Medical Director: Janice G. McFarland, M.D.
Director: Brian Curtis, PhD

Manager: Andrew Lochowicz

Consultant: Richard H. Aster, M.D.
 

Laboratory Phone (800) 245-3117, ext 6255