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The Nijmegen Hemostasis Assay: Simultaneous Fluorogenic Measurement of Thrombin and Plasmin Generation in a Single Well

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Interference in antiphospholipid antibody assays.

Gabriella Lakos¹

¹INOVA Diagnostics Inc., 9900 Old Grove Road, San Diego, CA 92131, USA. glakos@sd.inovadx.com

Seminars in Thrombosis and Hemostasis

|May 24, 2012

Summary

This summary is machine-generated.

Antiphospholipid antibody (aPL) testing involves immunoassays and coagulation assays, both susceptible to interferences. Understanding these limitations is crucial for accurate clinical interpretation of aPL test results.

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Area of Science:

Clinical Chemistry
Immunology
Hematology

Background:

Antiphospholipid antibodies (aPL) are crucial diagnostic markers.
Detection relies on antigen-specific immunoassays and functional coagulation assays.
Both assay types are vulnerable to various interferences, impacting diagnostic accuracy.

Purpose of the Study:

To highlight the prevalence and types of interferences in aPL testing.
To inform clinicians about the limitations of current aPL laboratory assays.
To emphasize the clinical significance of assay interferences.

Main Methods:

Review of antigen-specific immunoassays for antibodies against cardiolipin, β2-glycoprotein I, and phospholipid-protein complexes.
Analysis of functional (coagulation) assays for lupus anticoagulants.
Discussion of immune-mediated and non-immune-mediated interferences.

Main Results:

aPL immunoassays and coagulation assays are prone to significant interferences.
Interferences include heterophile antibodies, rheumatoid factor, high immunoglobulin levels, factor inhibitors, anticoagulants, and residual platelets.
Interferences are typically analyte- and assay-specific and may be overlooked in routine practice.

Conclusions:

Clinicians must be aware of the inherent limitations and potential interferences in aPL testing.
Despite advancements, complete elimination of interferences in aPL assays is unlikely.
Understanding assay interferences is vital for reliable clinical decision-making in antiphospholipid syndrome diagnosis.