Lupus anticoagulant increases activated partial thromboplastin time (PTT) prolongation in incubated 1:1 mix

Our study analyzes the effects of incubation time and strength of lupus anticoagulant (LAC) on clotting times and prolongation of activated partial thromboplastin time (PTT) 1:1 mix assays with incubation. The prolongation in seconds of PTT 1:1 mix after incubation in the confirmed presence or absence of LAC was correlated to strength of the LAC as well as length of incubation (1 vs. 2 hours). Our study suggests that when screening for possible Factor VIII (FVIII) inhibitors, a 2 hour incubation of a PTT 1:1 mix increases the frequency of false positives as compared to 1 hour incubation, and that most of these false positives are due to LACs. Prolongation of clotting times for PTT 1:1 mixes in patients with LAC is influenced by both length of incubation time and strength of the LAC.

When using PTT 1:1 mixes to screen for FVIII inhibitors, the effect of a possible LAC on the interpretation of the PTT prolongation should be considered. This effect is influenced by both incubation time and LAC strength.