Antiphospholipid syndrome: analysis of dilute Russell's viper venom time titer

To evaluate the characteristic features of the dilute Russell's viper venom time (DRVVT) titer in the antiphospholipid syndrome (APS). The medical record of 3660 consecutive patients with DRVVT orders between 2006 and 2015 were examined for criteria satisfying the diagnosis of APS. DRVVT titer was studied as a function of titer distribution, titer stability, and clinicopathologic features. Twenty-six patients were diagnosed with APS based on a persistently positive DRVVT and a history of arterial or venous thrombosis. DRVVT titer was mostly of low magnitude (65-77% of patients), was of similar value between initial and repeat testing (mean DRVVT titer 1.40 vs. 1.38; P = 0.858; mean time interval 216 days), and was positively associated with anticardiolipin antibodies (IgG and IgM) and antibeta-2-glycoprotein I antibodies (IgG and IgM) (P < 0.020). Low titer and moderate/high titer DRVVT were associated with a triple positive antiphospholipid antibody profile in 0 and 62% of patients, respectively (P < 0.020). DRVVT titer in APS was predominantly low in magnitude, stable over time, and associated with specific antiphospholipid antibody profiles.