Scholars@Duke
Grace Ming Lee

Grace Ming Lee

Assistant Professor of Medicine
Medicine, Hematology
304 Sands Buildiing, Box 3486, Durham, NC 27710
304 Sands Buildiing, Box 3486, Durham, NC 27710
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Selected Publications

Red cell exchange modulates neutrophil degranulation responses in sickle cell disease.

Journal Article Transfusion · July 9, 2024 BACKGROUND: Neutrophils in sickle cell disease (SCD) are activated, contributing to disease. Red cell exchange (RCE), with the goal of lowering hemoglobin S (HbS), is an important part of therapy for many SCD patients. Whether RCE impacts neutrophil reacti ... Full text Link to item Cite

Factitious disorder presenting as sickle cell disease: a case report

Journal Article The Lancet Regional Health - Americas · June 1, 2024 Full text Cite

Neutrophil functional heterogeneity is a fixed phenotype and is associated with distinct gene expression profiles.

Journal Article J Leukoc Biol · December 2022 Differences in the ability of neutrophils to perform relevant effector functions has been identified in a variety of disease states. Although neutrophil functional heterogeneity is increasingly recognized during disease, few studies have examined neutrophi ... Full text Link to item Cite

Minimal role for the alternative pathway in complement activation by HIT immune complexes.

Journal Article J Thromb Haemost · November 2022 BACKGROUND: Anti-platelet factor 4 (PF4)/heparin immune complexes that cause heparin-induced thrombocytopenia (HIT) activate complement via the classical pathway. Previous studies have shown that the alternative pathway of complement substantially amplifie ... Full text Link to item Cite

Complement mediates binding and procoagulant effects of ultralarge HIT immune complexes.

Journal Article Blood · November 25, 2021 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder mediated by ultra-large immune complexes (ULICs) containing immunoglobulin G (IgG) antibodies to a multivalent antigen composed of platelet factor 4 and heparin. The limitations of current ... Full text Link to item Cite

Can HIT testing lose its radioactivity?

Journal Article Blood · February 25, 2021 Full text Link to item Cite

Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.

Journal Article Blood Transfus · May 2020 BACKGROUND: Red blood cell (RBC) exchange (RCE) transfusion therapy is indicated for certain patients with sickle cell disease (SCD). Although beneficial, this therapy is costly and inconvenient to patients, who may require it monthly or more often. Identi ... Full text Link to item Cite

Heterogeneity in neutrophil responses to immune complexes.

Journal Article Blood Adv · October 8, 2019 Immune complexes (ICs) can trigger inflammation and thrombosis, in part, by activating neutrophils. Much attention has focused on the serologic characteristics of ICs and Fc receptors associated with cellular activation, but few studies have examined host ... Full text Link to item Cite

Polyreactive IgM initiates complement activation by PF4/heparin complexes through the classical pathway.

Journal Article Blood · December 6, 2018 The mechanisms by which exposure to heparin initiates antibody responses in many, if not most, recipients are poorly understood. We recently demonstrated that antigenic platelet factor 4 (PF4)/heparin complexes activate complement in plasma and bind to B c ... Full text Link to item Cite

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service.

Journal Article Immunohematology · June 2018 Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide ... Link to item Cite

Serologic characterization of anti-protamine/heparin and anti-PF4/heparin antibodies.

Journal Article Blood Adv · April 25, 2017 Anti-protamine (PRT)/heparin antibodies are a newly described class of heparin-dependent antibodies occurring in patients exposed to PRT and heparin during cardiac surgery. To understand the biologic significance of anti-PRT/heparin antibodies, we develope ... Full text Link to item Cite

The antigenic complex in HIT binds to B cells via complement and complement receptor 2 (CD21).

Journal Article Blood · October 6, 2016 Heparin-induced thrombocytopenia is a prothrombotic disorder caused by antibodies to platelet factor 4 (PF4)/heparin complexes. The mechanism that incites such prevalent anti-PF4/heparin antibody production in more than 50% of patients exposed to heparin i ... Full text Link to item Cite

The clinical and laboratory evaluation of the patient with erythrocytosis.

Journal Article Eur J Intern Med · June 2015 Erythrocytosis is frequently encountered as an incidental abnormality on laboratory testing that reveals persistent elevation of the hematocrit level (>52% in men and >48% in women). In many cases, erythrocytosis is the manifestation of an underlying cardi ... Full text Link to item Cite

Protamine-induced immune thrombocytopenia.

Journal Article Transfusion · October 2013 BACKGROUND: Protamine is widely used to reverse the anticoagulant effects of heparin. Although mild thrombocytopenia is common in patients given protamine after cardiac procedures, acute severe thrombocytopenia has not been described. We encountered a pati ... Full text Link to item Cite

Diagnosis and management of heparin-induced thrombocytopenia.

Journal Article Hematol Oncol Clin North Am · June 2013 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies to platelet factor 4/heparin (PF4/H) complexes. It presents with declining platelet counts 5 to 14 days after heparin administration and results in a predisposition to ... Full text Link to item Cite

High incidence of antibodies to protamine and protamine/heparin complexes in patients undergoing cardiopulmonary bypass.

Journal Article Blood · April 11, 2013 Protamine is routinely used to reverse heparin anticoagulation during cardiopulmonary bypass (CPB). Heparin interacts with protamine to form ultralarge complexes that are immunogenic in mice. We hypothesized that patients exposed to protamine and heparin d ... Full text Link to item Cite

Heparin-induced thrombocytopenia.

Journal Article Hematology Am Soc Hematol Educ Program · 2013 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies that recognize complexes of platelet factor 4 (PF4) and heparin. HIT is frequently considered in the differential diagnosis of thrombocytopenia occurring in patients on ... Full text Link to item Cite

Red cell exchange modulates neutrophil degranulation responses in sickle cell disease.

Journal Article Transfusion · July 9, 2024 BACKGROUND: Neutrophils in sickle cell disease (SCD) are activated, contributing to disease. Red cell exchange (RCE), with the goal of lowering hemoglobin S (HbS), is an important part of therapy for many SCD patients. Whether RCE impacts neutrophil reacti ... Full text Link to item Cite

Factitious disorder presenting as sickle cell disease: a case report

Journal Article The Lancet Regional Health - Americas · June 1, 2024 Full text Cite

Neutrophil functional heterogeneity is a fixed phenotype and is associated with distinct gene expression profiles.

Journal Article J Leukoc Biol · December 2022 Differences in the ability of neutrophils to perform relevant effector functions has been identified in a variety of disease states. Although neutrophil functional heterogeneity is increasingly recognized during disease, few studies have examined neutrophi ... Full text Link to item Cite

Minimal role for the alternative pathway in complement activation by HIT immune complexes.

Journal Article J Thromb Haemost · November 2022 BACKGROUND: Anti-platelet factor 4 (PF4)/heparin immune complexes that cause heparin-induced thrombocytopenia (HIT) activate complement via the classical pathway. Previous studies have shown that the alternative pathway of complement substantially amplifie ... Full text Link to item Cite

Complement mediates binding and procoagulant effects of ultralarge HIT immune complexes.

Journal Article Blood · November 25, 2021 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder mediated by ultra-large immune complexes (ULICs) containing immunoglobulin G (IgG) antibodies to a multivalent antigen composed of platelet factor 4 and heparin. The limitations of current ... Full text Link to item Cite

Can HIT testing lose its radioactivity?

Journal Article Blood · February 25, 2021 Full text Link to item Cite

Effects of repleting organic phosphates in banked erythrocytes on plasma metabolites and vasoactive mediators after red cell exchange transfusion in sickle cell disease.

Journal Article Blood Transfus · May 2020 BACKGROUND: Red blood cell (RBC) exchange (RCE) transfusion therapy is indicated for certain patients with sickle cell disease (SCD). Although beneficial, this therapy is costly and inconvenient to patients, who may require it monthly or more often. Identi ... Full text Link to item Cite

Heterogeneity in neutrophil responses to immune complexes.

Journal Article Blood Adv · October 8, 2019 Immune complexes (ICs) can trigger inflammation and thrombosis, in part, by activating neutrophils. Much attention has focused on the serologic characteristics of ICs and Fc receptors associated with cellular activation, but few studies have examined host ... Full text Link to item Cite

Polyreactive IgM initiates complement activation by PF4/heparin complexes through the classical pathway.

Journal Article Blood · December 6, 2018 The mechanisms by which exposure to heparin initiates antibody responses in many, if not most, recipients are poorly understood. We recently demonstrated that antigenic platelet factor 4 (PF4)/heparin complexes activate complement in plasma and bind to B c ... Full text Link to item Cite

Rh and Kell blood group antigen prevalence in a multi-ethnic cohort in Nigeria: implications for local transfusion service.

Journal Article Immunohematology · June 2018 Antigens belonging to the Rh and Kell blood group systems are of major clinical significance because of their immunogenicity and the potential of their consequent antibodies to cause in vivo destruction of exogenous red blood cells (RBCs). Despite the wide ... Link to item Cite

Serologic characterization of anti-protamine/heparin and anti-PF4/heparin antibodies.

Journal Article Blood Adv · April 25, 2017 Anti-protamine (PRT)/heparin antibodies are a newly described class of heparin-dependent antibodies occurring in patients exposed to PRT and heparin during cardiac surgery. To understand the biologic significance of anti-PRT/heparin antibodies, we develope ... Full text Link to item Cite

The antigenic complex in HIT binds to B cells via complement and complement receptor 2 (CD21).

Journal Article Blood · October 6, 2016 Heparin-induced thrombocytopenia is a prothrombotic disorder caused by antibodies to platelet factor 4 (PF4)/heparin complexes. The mechanism that incites such prevalent anti-PF4/heparin antibody production in more than 50% of patients exposed to heparin i ... Full text Link to item Cite

The clinical and laboratory evaluation of the patient with erythrocytosis.

Journal Article Eur J Intern Med · June 2015 Erythrocytosis is frequently encountered as an incidental abnormality on laboratory testing that reveals persistent elevation of the hematocrit level (>52% in men and >48% in women). In many cases, erythrocytosis is the manifestation of an underlying cardi ... Full text Link to item Cite

Protamine-induced immune thrombocytopenia.

Journal Article Transfusion · October 2013 BACKGROUND: Protamine is widely used to reverse the anticoagulant effects of heparin. Although mild thrombocytopenia is common in patients given protamine after cardiac procedures, acute severe thrombocytopenia has not been described. We encountered a pati ... Full text Link to item Cite

Diagnosis and management of heparin-induced thrombocytopenia.

Journal Article Hematol Oncol Clin North Am · June 2013 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies to platelet factor 4/heparin (PF4/H) complexes. It presents with declining platelet counts 5 to 14 days after heparin administration and results in a predisposition to ... Full text Link to item Cite

High incidence of antibodies to protamine and protamine/heparin complexes in patients undergoing cardiopulmonary bypass.

Journal Article Blood · April 11, 2013 Protamine is routinely used to reverse heparin anticoagulation during cardiopulmonary bypass (CPB). Heparin interacts with protamine to form ultralarge complexes that are immunogenic in mice. We hypothesized that patients exposed to protamine and heparin d ... Full text Link to item Cite

Heparin-induced thrombocytopenia.

Journal Article Hematology Am Soc Hematol Educ Program · 2013 Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder caused by antibodies that recognize complexes of platelet factor 4 (PF4) and heparin. HIT is frequently considered in the differential diagnosis of thrombocytopenia occurring in patients on ... Full text Link to item Cite

The zebra in the room.

Journal Article Journal of thrombosis and thrombolysis · January 2012 Full text Cite

Anticoagulation techniques in apheresis: from heparin to citrate and beyond.

Journal Article J Clin Apher · 2012 Anticoagulation is essential for maintaining the fluidity of extravascular blood on the apheresis circuit. Although both citrate and heparin are used as an anticoagulant during apheresis, citrate is preferred for the majority of exchange procedures because ... Full text Link to item Cite

Risk of major bleeding with concomitant dual antiplatelet therapy after percutaneous coronary intervention in patients receiving long-term warfarin therapy.

Journal Article Pharmacotherapy · May 2007 STUDY OBJECTIVES: To characterize the safety of concomitant aspirin, clopidogrel, and warfarin therapy after percutaneous coronary intervention (PCI), and to identify patient characteristics that increase the risk of hemorrhage. DESIGN: Retrospective, matc ... Full text Link to item Cite