Spectrum of anti-PF4 disorders widens
June 2025—For a relatively sleepy field of study, heparin-induced thrombocytopenia has produced more than its share of thrills in the past few years. HIT (sometimes called HITT, with the extra “T” denoting thrombosis) gave way to urgent discussions about vaccine-induced immune thrombotic thrombocytopenia, or VITT, at one particularly panicky point in the COVID-19 pandemic. Take another spin of the wheel: “VITT-like” is now primarily used to refer to cases in which patients have received neither heparin nor a vaccine. Even more recently, researchers have identified a new syndrome, referred to as monoclonal gammopathy of thrombotic significance (MGTS). Publications have put this disorder into three groups. “I think this is going to be the biggest thing in the thrombophilia field in a long time,” predicts Anand Padmanabhan, MD, PhD, professor, Mayo Clinic. Unlike HIT and VITT, MGTS is a chronic condition. “It may end up being part of a thrombophilia profile in the coming years.”