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Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Lupus anticoagulant testing using two parallel methods detects additional cases and predicts persistent positivity.

Daimon P Simmons1, Adrianna Z Herskovits1, Elisabeth M Battinelli2

  • 1Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.

Clinical Chemistry and Laboratory Medicine
|June 16, 2016
PubMed
Summary
This summary is machine-generated.

Evaluating two lupus anticoagulant (LA) tests in antiphospholipid antibody syndrome (APS) showed that using both methods improves diagnostic information. Persistent positivity and co-occurrence with other antiphospholipid antibodies (aPL) were observed.

Keywords:
anticardiolipinantiphospholipid antibodiesantiβ2-glycoprotein Ilupus anticoagulantthrombosis

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Area of Science:

  • Hematology
  • Clinical Immunology
  • Diagnostic Medicine

Background:

  • Antiphospholipid antibody syndrome (APS) involves antiphospholipid antibodies (aPL) and clinical events like thrombosis or pregnancy morbidity.
  • International guidelines recommend specific tests for lupus anticoagulant (LA), including PTT-LA and dilute Russell's viper venom time (DRVVT).

Purpose of the Study:

  • To evaluate the clinical utility of performing two different LA testing modalities in parallel.
  • To assess the correlation of LA results with anticardiolipin (ACL) and anti-β2-glycoprotein I (aB2GPI) antibodies and clinical history.

Main Methods:

  • A tertiary care center's specialized coagulation laboratory implemented parallel testing for LA using PTT-LA and DRVVT.
  • Results from one year of aPL testing were collected, and chart reviews correlated LA findings with ACL, aB2GPI, and patient clinical history.

Main Results:

  • Patients positive by both PTT-LA and DRVVT were more likely to have persistent LA positivity.
  • Positivity for ACL and aB2GPI correlated with positivity in both LA methodologies.
  • No single LA test was fully sensitive; APS cases were identified by PTT-LA only, DRVVT only, or both methods.

Conclusions:

  • Implementing a second LA testing method provides valuable diagnostic information.
  • Parallel LA testing may aid in risk stratification for thrombosis in patients with suspected APS.