Updates in Antiphospholipid Syndrome Laboratory Diagnosis.

Area of Science:

• Hematology
• Clinical Chemistry
• Rheumatology

Background:

• Antiphospholipid syndrome (APS) diagnosis has advanced, yet laboratory practices, particularly lupus anticoagulant (LA) testing, need standardization.
• LA testing in patients on anticoagulation therapy is frequent but poses challenges, potentially causing false positive or negative results.

Purpose of the Study:

• To address the need for standardized laboratory practices in antiphospholipid syndrome (APS) diagnosis.
• To improve the accuracy of lupus anticoagulant (LA) testing in anticoagulated patients.

Main Methods:

• Investigating methods to improve LA testing accuracy in anticoagulated patients, including activated carbon pre-treatment and alternative LA reagents.
• Evaluating the harmonization of solid-phase antiphospholipid antibody testing in light of recent guideline discrepancies.

Main Results:

• Activated carbon pre-treatment or alternative LA reagents can improve the accuracy of LA testing in anticoagulated patients.
• Solid-phase antiphospholipid antibody testing lacks complete harmonization, with differing recommendations from major international societies.

Conclusions:

• Further standardization of laboratory practices is crucial for accurate APS diagnosis, especially concerning LA testing in anticoagulated individuals.
• Specific pre-treatments or reagents can mitigate issues with LA testing in anticoagulated patients, but harmonization of solid-phase assays remains a challenge.