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Some recent developments with lupus anticoagulants

T Exner1

  • 1Haemostasis Reference Laboratory, Westmead Hospital, Sydney, NSW, Australia.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|April 1, 1994
PubMed
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Lupus anticoagulants (LA) are antibodies interfering with phospholipids. New diagnostic tests improve sensitivity and specificity, aiding in classifying these complex circulating anticoagulants.

Area of Science:

  • Coagulation science
  • Immunology

Background:

  • Lupus anticoagulants (LA) are phospholipid-interfering antibodies.
  • LA testing is a common coagulation laboratory procedure.
  • Recent advancements offer new diagnostic methods.

Purpose of the Study:

  • To review recent advancements in lupus anticoagulant testing.
  • To discuss methods for improving LA detection sensitivity and specificity.
  • To explore the heterogeneity of LA mechanisms.

Main Methods:

  • Utilizing activated partial thromboplastin time (aPTT) reagents with modified phospholipids for high sensitivity.
  • Employing heparin-resistant correction procedures based on aPTT and dilute Russell's viper venom time (DRVVT) with hexagonal phase phospholipids for specificity.
  • Implementing simplified tests using venom activators of factor X and prothrombin for improved reliability and categorization.

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Main Results:

  • New aPTT reagents enhance LA detection sensitivity.
  • Heparin-resistant correction procedures improve LA test specificity.
  • Simplified venom-based tests aid in categorizing circulating anticoagulants.
  • Studies confirm LA heterogeneity, with some requiring beta 2-glycoprotein 1 and others human prothrombin.

Conclusions:

  • Recent innovations have significantly improved lupus anticoagulant testing.
  • Enhanced sensitivity and specificity aid in accurate LA diagnosis.
  • Understanding LA heterogeneity is crucial for effective patient management.