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Antibodies 2016, 5(4), 22; doi:10.3390/antib5040022

Current Controversies in Lupus Anticoagulant Detection

Diagnostic Haemostasis & Thrombosis Laboratories, Department of Haemostasis and Thrombosis, Viapath Analytics, Guy’s & St. Thomas’ NHS Foundation Hospitals Trust, 4th floor North Wing, St. Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
Academic Editor: Ricard Cervera
Received: 27 September 2016 / Revised: 17 November 2016 / Accepted: 18 November 2016 / Published: 2 December 2016
(This article belongs to the Special Issue Antiphospholipid Antibodies and Syndrome)
View Full-Text   |   Download PDF [248 KB, uploaded 6 December 2016]

Abstract

Antiphospholipid syndrome is an autoimmune, acquired thrombophilia diagnosed when vascular thrombosis or pregnancy morbidity are accompanied by persistent antiphospholipid antibodies. Lupus anticoagulants (LA) are one of the criteria antibodies but calibration plasmas are unavailable and they are detected by inference based on antibody behaviour in a medley of coagulation-based assays. Elevated screening tests suggest the presence of a LA, which is confirmed with mixing tests to evidence inhibition and confirmatory tests to demonstrate phospholipid-dependence. At least two screening tests of different principle must be used to account for antibody heterogeneity and controversy exists on whether assays, in addition to dilute Russell’s viper venom time and activated partial thromboplastin time, should be employed. A variety of approaches to raw data manipulation and interpretation attract debate, as does inclusion or exclusion of mixing studies in circumstances where the presence of a LA is already evident from other results. Therapeutic anticoagulation compromises coagulation-based assays but careful data interpretation and use of alternative reagents can detect or exclude LA in specific circumstances, and this aspect of LA detection continues to evolve. This review focuses on the main areas of debate in LA detection. View Full-Text
Keywords: activated partial thromboplastin time; antiphospholipid antibodies; antiphospholipid syndrome; dilute prothrombin time; dilute Russell’s viper venom time; lupus anticoagulant; mixing tests; Taipan snake venom time activated partial thromboplastin time; antiphospholipid antibodies; antiphospholipid syndrome; dilute prothrombin time; dilute Russell’s viper venom time; lupus anticoagulant; mixing tests; Taipan snake venom time
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Moore, G.W. Current Controversies in Lupus Anticoagulant Detection. Antibodies 2016, 5, 22.

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