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  1. Article ; Online: COVID vaccine-induced immune thrombotic thrombocytopenia: Rare but relevant.

    Greinacher, Andreas

    European journal of internal medicine

    2022  Volume 105, Page(s) 20–22

    MeSH term(s) Humans ; COVID-19 Vaccines/adverse effects ; COVID-19 ; Purpura, Thrombocytopenic, Idiopathic/chemically induced ; Thrombocytopenia/chemically induced ; Thrombosis ; Vaccines
    Chemical Substances COVID-19 Vaccines ; Vaccines
    Language English
    Publishing date 2022-09-17
    Publishing country Netherlands
    Document type Journal Article ; Comment
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2022.09.012
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    Zs.A 2608: Show issues Location:
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  2. Article ; Online: An interdisciplinary approach to diagnose and manage Heparin-induced Thrombocytopenia.

    Greinacher, Andreas

    Anaesthesia, critical care & pain medicine

    2020  Volume 39, Issue 2, Page(s) 197–198

    MeSH term(s) Anticoagulants/adverse effects ; Heparin/adverse effects ; Humans ; Thrombocytopenia/chemically induced ; Thrombocytopenia/diagnosis ; Thrombocytopenia/therapy
    Chemical Substances Anticoagulants ; Heparin (9005-49-6)
    Language English
    Publishing date 2020-03-04
    Publishing country France
    Document type Editorial
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2020.03.002
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  3. Book: Heparin induced thrombocytopenia

    Warkentin, Theodore E. / Greinacher, Andreas

    (Fundamental and clinical cardiology)

    2013  

    Title variant Heparin-induced thrombocytopenia
    Author's details ed. by Theodore E. Warkentin ; Andreas Greinacher
    Series title Fundamental and clinical cardiology
    Keywords Thrombocytopenia / chemically induced ; Anticoagulants / therapeutic use ; Heparin / adverse effects
    Language English
    Size XI, 641 S. : Ill., graph. Darst.
    Edition 5. ed.
    Publisher CRC Press
    Publishing place Boca Raton u.a.
    Publishing country United States
    Document type Book
    Note Includes bibliographical references and index
    HBZ-ID HT017327898
    ISBN 978-1-8418-4860-0 ; 978-1-84184-860-0 ; 1-84184-860-3 ; 1-8418-4860-3 ; 9781841848617 ; 1841848611
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2012 A 5688 order for loan Magazin

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  4. Article ; Online: Vaccine-induced immune thrombotic thrombocytopenia.

    Cines, Douglas B / Greinacher, Andreas

    Blood

    2023  Volume 141, Issue 14, Page(s) 1659–1665

    Abstract: Within the first months of the COVID-19 vaccination campaign, previously healthy recipients who developed severe thrombosis (often cerebral and/or splanchnic vasculature) and thrombocytopenia typically after adenoviral vector-based vaccination were ... ...

    Abstract Within the first months of the COVID-19 vaccination campaign, previously healthy recipients who developed severe thrombosis (often cerebral and/or splanchnic vasculature) and thrombocytopenia typically after adenoviral vector-based vaccination were identified. Similarities between this syndrome, vaccine-induced immune thrombotic thrombocytopenia (VITT), and heparin-induced thrombocytopenia prompted recognition of the role of antiplatelet factor 4 (PF4) antibodies and management strategies based on IV immunoglobulin and nonheparin anticoagulants, which improved outcome. We update current understanding of VITT and potential involvement of anti-PF4 antibodies in thrombotic disorders.
    MeSH term(s) Humans ; COVID-19 Vaccines/adverse effects ; COVID-19 ; Purpura, Thrombocytopenic, Idiopathic/chemically induced ; Purpura, Thrombocytopenic, Idiopathic/therapy ; Thrombocytopenia/chemically induced ; Thrombosis/etiology ; Vaccines ; Platelet Factor 4
    Chemical Substances COVID-19 Vaccines ; Vaccines ; Platelet Factor 4 (37270-94-3)
    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2022017696
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 364: Show issues

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  5. Article ; Online: Platelet factor 4 triggers thrombo-inflammation by bridging innate and adaptive immunity.

    Greinacher, Andreas / Warkentin, Theodore E

    International journal of laboratory hematology

    2023  Volume 45 Suppl 2, Page(s) 11–22

    Abstract: Platelet factor 4 (PF4, synonym: CXCL4) is an evolutionary old chemokine with proposed roles in hemostasis and antimicrobial defense. In addition, PF4 has attracted considerable attention as a crucial mediator of one of the most prothrombotic adverse ... ...

    Abstract Platelet factor 4 (PF4, synonym: CXCL4) is an evolutionary old chemokine with proposed roles in hemostasis and antimicrobial defense. In addition, PF4 has attracted considerable attention as a crucial mediator of one of the most prothrombotic adverse drug effects affecting blood cells, heparin-induced thrombocytopenia (HIT). Interest in PF4 substantially increased in 2021 when it was identified as the target antigen in the life-threatening adverse effect, vaccine-induced immune thrombotic thrombocytopenia (VITT). We address the concept that a major biological function of PF4-a strongly cationic chemokine-is to bind to negatively-charged prokaryotic microorganisms, resulting in structural changes in PF4 that trigger a danger signal recognized by the adaptive immune system. Application of biophysical tools has provided substantial insights into the molecular mechanisms by which PF4 becomes immunogenic, providing insights into a new mechanism of autoimmunity. Binding of autoantibodies with high affinity induces conformational change(s) in the endogenous protein, which are then recognized as foreign antigen, as exemplified by the prothrombotic disorders, autoimmune HIT and VITT. The final part of our review summarizes current assays for HIT and VITT, explaining how structural aspects of anti-PF4 pathobiology relate to assay design and performance characteristics. Currently, functional (platelet activation) assays using washed platelets detect HIT antibodies when heparin is added, and VITT antibodies when PF4 is added. Solid-phase PF4-dependent immunoassays using microtiter plates are sensitive for both HIT and VITT antibodies, while rapid immunoassays, in which the PF4/heparin antigen is coated on beads, are sensitive and specific for HIT, but not for VITT antibodies.
    MeSH term(s) Humans ; Adaptive Immunity ; Autoantibodies ; Heparin/adverse effects ; Inflammation ; Platelet Factor 4 ; Thrombocytopenia ; Immunity, Innate
    Chemical Substances Autoantibodies ; Heparin (9005-49-6) ; Platelet Factor 4 (37270-94-3) ; PF4 protein, human
    Language English
    Publishing date 2023-05-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2268590-X
    ISSN 1751-553X ; 1751-5521 ; 0141-9854
    ISSN (online) 1751-553X
    ISSN 1751-5521 ; 0141-9854
    DOI 10.1111/ijlh.14075
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    Zs.A 1499: Show issues Location:
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  6. Article ; Online: Thrombotic anti-PF4 immune disorders: HIT, VITT, and beyond.

    Greinacher, Andreas / Warkentin, Theodore E

    Hematology. American Society of Hematology. Education Program

    2023  Volume 2023, Issue 1, Page(s) 1–10

    Abstract: Antibodies against the chemokine platelet factor 4 (PF4) occur often, but only those that activate platelets induce severe prothrombotic disorders with associated thrombocytopenia. Heparin-induced thrombocytopenia (HIT) is the prototypic anti-PF4 ... ...

    Abstract Antibodies against the chemokine platelet factor 4 (PF4) occur often, but only those that activate platelets induce severe prothrombotic disorders with associated thrombocytopenia. Heparin-induced thrombocytopenia (HIT) is the prototypic anti-PF4 disorder, mediated by strong activation of platelets through their FcγIIa (immunoglobulin G [IgG]) receptors (FcγRIIa). Concomitant pancellular activation (monocytes, neutrophils, endothelium) triggers thromboinflammation with a high risk for venous and arterial thrombosis. The classic concept of HIT is that anti-PF4/heparin IgG, recognizing antigen sites on (cationic) PF4 that form in the presence of (anionic) heparin, constitute the heparin-dependent antibodies that cause HIT. Accordingly, HIT is managed by anticoagulation with a nonheparin anticoagulant. In 2021, adenovirus vector COVID-19 vaccines triggered the rare adverse effect "vaccine-induced immune thrombotic thrombocytopenia" (VITT), also caused by anti-PF4 IgG. VITT is a predominantly heparin-independent platelet-activating disorder that requires both therapeutic-dose anticoagulation and inhibition of FcγRIIa-mediated platelet activation by high-dose intravenous immunoglobulin (IVIG). HIT and VITT antibodies bind to different epitopes on PF4; new immunoassays can differentiate between these distinct HIT-like and VITT-like antibodies. These studies indicate that (1) severe, atypical presentations of HIT ("autoimmune HIT") are associated with both HIT-like (heparin-dependent) and VITT-like (heparin-independent) anti-PF4 antibodies; (2) in some patients with severe acute (and sometimes chronic, recurrent) thrombosis, VITT-like antibodies can be identified independent of proximate heparin exposure or vaccination. We propose to classify anti-PF4 antibodies as type 1 (nonpathogenic, non- platelet activating), type 2 (heparin dependent, platelet activating), and type 3 (heparin independent, platelet activating). A key concept is that type 3 antibodies (autoimmune HIT, VITT) require anticoagulation plus an adjunct treatment, namely high-dose IVIG, to deescalate the severe anti-PF4 IgG-mediated hypercoagulability state.
    MeSH term(s) Humans ; Platelet Factor 4/adverse effects ; Platelet Factor 4/metabolism ; Immunoglobulins, Intravenous/therapeutic use ; COVID-19 Vaccines/adverse effects ; Inflammation ; Thrombosis/drug therapy ; Thrombocytopenia/chemically induced ; Thrombocytopenia/therapy ; Heparin/adverse effects ; Anticoagulants/adverse effects ; Antibodies ; Purpura, Thrombocytopenic, Idiopathic/diagnosis ; Purpura, Thrombocytopenic, Idiopathic/therapy ; Immunologic Factors/adverse effects
    Chemical Substances Platelet Factor 4 (37270-94-3) ; Immunoglobulins, Intravenous ; COVID-19 Vaccines ; Heparin (9005-49-6) ; Anticoagulants ; Antibodies ; Immunologic Factors
    Language English
    Publishing date 2023-12-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2084287-9
    ISSN 1520-4383 ; 1520-4391
    ISSN (online) 1520-4383
    ISSN 1520-4391
    DOI 10.1182/hematology.2023000503
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  7. Book ; Online: Empfehlungen zur Thrombozytentransfusion

    Greinacher, Andreas

    ([Onkopedia Leitlinien])

    2006  

    Institution Deutsche Gesellschaft für Hämatologie und Onkologie
    Deutsche Gesellschaft für Transfusionsmedizin und Immunhämatologie
    Gesellschaft für Thrombose- und Hämostaseforschung
    Author's details Thrombozyten Arbeitsgruppe der DGTI, GTH und DGHO ; Andreas Greinacher (Korr, DGTI), Volker Kiefel (DGTI), Harald Klüter (DGTI), Hartmut Kroll (DGTI), Bernd Pötzsch (GTH), Hanno Riess (DGTI, DGHO)
    Series title [Onkopedia Leitlinien]
    Subject code 610
    Language German
    Size 1 Online-Ressource (41 Seiten)
    Edition Stand: Oktober 2006
    Publisher Deutsche Gesellschaft für Hämatologie und Onkologie
    Publishing place Berlin
    Publishing country Germany
    Document type Book ; Online
    HBZ-ID HT019108127
    DOI 10.4126/FRL01-006400929
    Database Repository for Life Sciences

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  8. Article ; Online: Dangerous B-cell clones.

    Greinacher, Andreas / Nimmerjahn, Falk

    Blood

    2022  Volume 140, Issue 15, Page(s) 1663–1665

    MeSH term(s) B-Lymphocytes ; Clone Cells ; Lymphocyte Activation
    Language English
    Publishing date 2022-10-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 80069-7
    ISSN 1528-0020 ; 0006-4971
    ISSN (online) 1528-0020
    ISSN 0006-4971
    DOI 10.1182/blood.2022017339
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    Zs.MO 364: Show issues

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  9. Book ; Thesis: Blutversorgungskonzepte für kritisch kranke Patienten

    Selleng, Kathleen / Greinacher, Andreas / Kiefel, Volker / Klüter, Harald

    ein transfusionsmedizinischer Beitrag zur interdisziplinären Hämotherapie

    2018  

    Institution Universität Greifswald
    Author's details vorgelegt von Kathleen Selleng ; 1. Gutachter: Prof. Dr. med. Andreas Greinacher, Universitätsmedizin Greifswald, 2. Gutachter: Prof. Dr. med. Volker Kiefel, Universitätsmedizin Rostock, 3. Gutachter: Prof. Dr. med. Harald Klüter, Medizinische Fakultät Mannheim der Universität Heidelberg
    Language German ; English
    Size 1 Band (verschiedene Seitenzählungen), Illustrationen (teilweise farbig), Diagramme (teilweise farbig)
    Publishing place Greifswald
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Habilitationsschrift, Universitätsmedizin der Universität Greifswald, 2019
    Note Text deutsch, Anhang englisch ; Literaturverzeichnis: Blatt 32-37
    HBZ-ID HT020398169
    Database Catalogue ZB MED Medicine, Health

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    Shelf markLoan statusLocation
    2020 E 493 order for loan Magazin

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  10. Book ; Conference proceedings: HIT II - von der Awareness zur Therapie

    Greinacher, Andreas

    Experten-Workshop, 17. - 18. November 2001, Bremen

    (Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie ; 37, Suppl. 1)

    2002  

    Author's details Gasthrsg.: A. Greinacher
    Series title Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie ; 37, Suppl. 1
    Collection
    Language German
    Size S25 S. : graph. Darst.
    Publisher Thieme
    Publishing place Stuttgart
    Publishing country Germany
    Document type Book ; Conference proceedings
    Note Kongressjahr auf Umschlag fälschl. mit 2002 angegeben
    HBZ-ID HT013369615
    Database Catalogue ZB MED Medicine, Health

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    Zs A 257 -37,Suppl.1- not available for loan Zeitschriften-Lesesaal

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