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Reconstitution Of β-catenin Degradation In Xenopus Egg Extract
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In ECAT veritas?

G Reber1, P Meijer

  • 1Genetics and Laboratory Medicine Department, Geneva University Hospital and Faculty of Medicine, University of Geneva, Switzerland. guido.reber@hcuge.ch

Lupus
|May 29, 2012
PubMed
Summary
This summary is machine-generated.

External quality control surveys reveal significant variability in classifying weak lupus anticoagulant (LA) samples. Integrated assays are recommended for improved detection of these challenging LA cases.

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Area of Science:

  • Clinical Immunology
  • Hematology
  • Diagnostic Laboratory Medicine

Background:

  • Antiphospholipid syndrome diagnosis relies on lupus anticoagulant (LA), anticardiolipin (aCL), and anti-ß(2)glycoprotein I (aß(2)GPI) assays.
  • External quality control (EQC) demonstrates high accuracy for clearly positive/negative LA samples but wide variability for weak LA.
  • Weak LA samples show inconsistent classification across different EQC surveys and laboratories.

Purpose of the Study:

  • To investigate the classification variability of weak lupus anticoagulant (LA) samples in external quality control (EQC) surveys.
  • To identify reasons for misclassification of weak LA samples.
  • To propose improved methods for detecting weak LA.

Main Methods:

  • Analysis of results from external quality control (EQC) surveys involving lupus anticoagulant (LA) testing.
  • Evaluation of laboratory classifications for weak LA samples, including results from mixing tests.
  • Comparison of weak LA sample classifications across different EQC surveys and with other antiphospholipid antibody assays (aCL, aß(2)GPI).

Main Results:

  • About 95% of laboratories correctly classify clearly positive and negative LA samples.
  • Weak LA samples exhibit significant classification variability among laboratories and across EQC surveys.
  • Over 50% of laboratories misclassify weak LA samples when tested in different EQC surveys.
  • Weak LA samples were often misclassified as positive for aCL and aß(2)GPI antibodies.
  • A negative mixing test was a common reason for classifying weak LA samples as negative.

Conclusions:

  • The detection of weak lupus anticoagulant (LA) is challenging and shows high inter-laboratory variability.
  • Current laboratory criteria and assays may not reliably detect all cases of weak LA.
  • Integrated assays, such as those employing screen/confirm ratios, are recommended for improved detection of weak LA samples.