Current Controversies in Lupus Anticoagulant Detection
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 de...
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| Format: | Article |
| Language: | English |
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MDPI AG
2016-12-01
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| Series: | Antibodies |
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| Online Access: | http://www.mdpi.com/2073-4468/5/4/22 |
| _version_ | 1811269334428811264 |
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| author | Gary W. Moore |
| author_facet | Gary W. Moore |
| author_sort | Gary W. Moore |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T21:40:14Z |
| format | Article |
| id | doaj.art-c674bac84c9549629cca254d839709d4 |
| institution | Directory Open Access Journal |
| issn | 2073-4468 |
| language | English |
| last_indexed | 2024-04-12T21:40:14Z |
| publishDate | 2016-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibodies |
| spelling | doaj.art-c674bac84c9549629cca254d839709d42022-12-22T03:15:48ZengMDPI AGAntibodies2073-44682016-12-01542210.3390/antib5040022antib5040022Current Controversies in Lupus Anticoagulant DetectionGary W. Moore0Diagnostic 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, UKAntiphospholipid 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.http://www.mdpi.com/2073-4468/5/4/22activated partial thromboplastin timeantiphospholipid antibodiesantiphospholipid syndromedilute prothrombin timedilute Russell’s viper venom timelupus anticoagulantmixing testsTaipan snake venom time |
| spellingShingle | Gary W. Moore Current Controversies in Lupus Anticoagulant Detection Antibodies 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 |
| title | Current Controversies in Lupus Anticoagulant Detection |
| title_full | Current Controversies in Lupus Anticoagulant Detection |
| title_fullStr | Current Controversies in Lupus Anticoagulant Detection |
| title_full_unstemmed | Current Controversies in Lupus Anticoagulant Detection |
| title_short | Current Controversies in Lupus Anticoagulant Detection |
| title_sort | current controversies in lupus anticoagulant detection |
| topic | 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 |
| url | http://www.mdpi.com/2073-4468/5/4/22 |
| work_keys_str_mv | AT garywmoore currentcontroversiesinlupusanticoagulantdetection |