Related Experiment Video
Updated: Oct 25, 2025
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Diagnostic Challenges on the Laboratory Detection of Lupus Anticoagulant
1IRCCS Ca' Granda Ospedale Maggiore Foundation, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Via Pace 9, 20122 Milano, Italy.
Insights
Lupus anticoagulant (LA) testing presents significant challenges for clinical laboratories due to the absence of specific tests. Standardizing LA detection is crucial for managing antiphospholipid syndrome (APS) and guiding patient anticoagulation therapy.
Area of Science:
- Clinical Chemistry
- Hematology
- Immunology
Background:
- Lupus anticoagulant (LA) is a key diagnostic marker for antiphospholipid syndrome (APS).
- Accurate LA detection is critical for patient management, particularly regarding long-term anticoagulation.
- Current diagnostic methods for LA are complex and lack specificity.
Purpose of the Study:
- To review the current state-of-the-art in Lupus Anticoagulant (LA) detection.
- To highlight the challenges faced by clinical laboratories in accurately diagnosing LA.
- To emphasize the importance of standardized LA testing for Antiphospholipid Syndrome (APS) management.
Main Methods:
- Review of established guidelines for LA detection over the past two decades.
- Discussion of diagnostic complexities and limitations in current LA testing protocols.
- Emphasis on the role of external quality assessment schemes in standardizing LA diagnostics.
Main Results:
- LA testing remains a complex diagnostic challenge for clinical laboratories.
- Standardized protocols and quality assessments are essential for reliable LA detection.
- Persistent LA positivity influences long-term anticoagulation decisions in APS patients.
Conclusions:
- Standardization of LA detection methods is paramount for accurate APS diagnosis and patient care.
- Clinical laboratories face ongoing challenges in implementing and maintaining reliable LA testing.
- Adherence to guidelines and participation in quality assessments are vital for improving LA detection accuracy.
Abstract:
Lupus anticoagulant (LA) is one of the three laboratory parameters (the others being antibodies to either cardiolipin or β2-glycoprotein I) which defines the rare but potentially devastating condition known as antiphospholipid syndrome (APS). Testing for LA is a challenging task for the clinical laboratory because specific tests for its detection are not available. However, proper LA detection is paramount for patients' management, as its persistent positivity in the presence of (previous or current) thrombotic events, candidate for long term anticoagulation. Guidelines for LA detection have been established and updated over the last two decades. Implementation of these guidelines across laboratories and participation to external quality assessment schemes are required to help standardize the diagnostic procedures and help clinicians for appropriate management of APS. This article aims to review the current state of the art and the challenges that clinical laboratories incur in the detection of LA.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies