Update of the guidelines for lupus anticoagulant detection

Summary.  One of the conclusions of the subcommittee meeting on Lupus Anticoagulant/Phospholipid dependent antibodies, held in Geneva on 2007, was the need to update the guidelines on Lupus Anticoagulant (LA) detection. Particular emphasis was given to several aspects discussed in this official communication. A new paragraph is dedicated to the patient selection, and aims to minimize inappropriate requests for LA testing. Modalities for blood collection and processing are fully delineated and the choice of tests is limited to dRVVT and a sensitive aPTT. Calculation of cut‐off values for each diagnostic step are clearly stated. A final paragraph reports the interpretation of the results in general and in particular situations.

[1]  Pojen P. Chen,et al.  Hydroxychloroquine directly reduces the binding of antiphospholipid antibody-beta2-glycoprotein I complexes to phospholipid bilayers. , 2008, Blood.

[2]  P. D. de Groot,et al.  Current insight into diagnostics and pathophysiology of the antiphospolipid syndrome. , 2008, Blood reviews.

[3]  F. Marongiu,et al.  A comparison of lupus anticoagulant-positive patients with clinical picture of antiphospholipid syndrome and those without. , 2007, Arteriosclerosis, thrombosis, and vascular biology.

[4]  S. Testa,et al.  Survey of lupus anticoagulant diagnosis by central evaluation of positive plasma samples , 2007, Journal of thrombosis and haemostasis : JTH.

[5]  Y. Shoenfeld,et al.  International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS) , 2006, Journal of thrombosis and haemostasis : JTH.

[6]  E. Duncan,et al.  Multilaboratory testing of thrombophilia: current and past practice in Australasia as assessed through the Royal College of Pathologists of Australasia Quality Assurance Program for Hematology. , 2005, Seminars in thrombosis and hemostasis.

[7]  A. Biasiolo,et al.  Lupus anticoagulant (LA) testing: performance of clinical laboratories assessed by a national survey using lyophilized affinity-purified immunoglobulin with LA activity. , 2003, Clinical chemistry.

[8]  G. Moore,et al.  The Ecarin time is an improved confirmatory test for the Taipan snake venom time in warfarinized patients with lupus anticoagulants , 2003, Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.

[9]  P. Mannucci,et al.  Laboratory Diagnosis of Lupus Anticoagulants for Patients on Oral Anticoagulant Treatment , 2002, Thrombosis and Haemostasis.

[10]  D. Triplett,et al.  The Lupus Ratio Test – An Interlaboratory Study on the Detection of Lupus Anticoagulants by an APTT-based, Integrated, and Semi-quantitative Test , 2000, Thrombosis and Haemostasis.

[11]  J. Vermylen,et al.  Lupus Anticoagulant Testing in Europe: An Analysis of Results from the First European Concerted Action on Thrombophilia (ECAT) Survey Using Plasmas Spiked with Monoclonal Antibodies against Human β2-Glycoprotein I , 1999, Thrombosis and Haemostasis.

[12]  M. Greaves,et al.  Potentially Clinically Important Inaccuracies in Testing for the Lupus Anticoagulant: an Analysis of Results from three Surveys of the UK National External Quality Assessment Scheme (NEQAS) for Blood Coagulation , 1997, Thrombosis and Haemostasis.

[13]  I. Scharrer,et al.  Criteria for the Diagnosis of Lupus Anticoagulants: An Update , 1995, Thrombosis and Haemostasis.

[14]  T. Barbui,et al.  Kaolin clotting time and dilute Russell's viper venom time distinguish between prothrombin-dependent and beta 2-glycoprotein I-dependent antiphospholipid antibodies. , 1995, Blood.

[15]  D. Triplett,et al.  The Textarin/Ecarin Ratio: A Confirmatory Test for Lupus Anticoagulants , 1993, Thrombosis and Haemostasis.

[16]  D. Triplett,et al.  A Hexagonal (II) Phase Phospholipid Neutralization Assay for Lupus Anticoagulant Identification , 1993, Thrombosis and Haemostasis.

[17]  M. Modan,et al.  Detection and Quantitative Evaluation of Lupus Circulating Anticoagulant Activity , 1987, Thrombosis and Haemostasis.

[18]  E. Favaloro Preanalytical variables in coagulation testing. , 2007, Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.