Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 53: 1629-1635, 2007; 10.1373/clinchem.2007.089524
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tripodi, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tripodi, A.
Related Collections
Right arrow Clinical Immunology
Right arrow Hemostasis and Thrombosis
(Clinical Chemistry. 2007;53:1629-1635.)
© 2007 American Association for Clinical Chemistry, Inc.

Hemostasis and Thrombosis

Laboratory Testing for Lupus Anticoagulants: A Review of Issues Affecting Results

Armando Tripodi

Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine, University of Milan and IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milano, Italy.

Address correspondence to the author at: Via Pace 9, 20122 Milano, Italy. Fax 39-02-50320723; e-mail armando.tripodi{at}unimi.it.

Background: Lupus anticoagulants (LA) are a heterogeneous class of immunoglobulins. Persistent LA positivity is a risk factor for the occurrence and recurrence of venous/arterial thromboembolism and/or pregnancy morbidity and qualifies the patient for anticoagulation therapy. The laboratory diagnosis for LA that is used for crucial decision-making about the optimal duration of the therapy rests entirely on diagnostic criteria. These criteria are based on the prolongation of phospholipid-dependent tests not corrected upon mixing patient and normal plasmas, with confirmation provided by the evidence that the anticoagulant is directed against proteins bound to negatively charged phospholipids.

Aims: This article reviews issues related to the diagnosis of LA, including the effect of preanalytical variables, choice of tests, results interpretation of screening, mixing and confirmation procedures, patients to be investigated, and transmission of results. Unresolved issues and future direction for research on laboratory diagnosis are also discussed.

Methods: Search of PubMed with the key term "lupus anticoagulant" plus articles and unpublished data known to the author.

Results and Conclusions: The preanalytical variables (i.e., plasma preparation and storage before analysis) as well as the diagnostic steps to detect LA present potential problems that undermine the process of making a correct diagnosis. A truly specific test for LA detection is badly needed, but its development may require understanding of the mechanisms associated with the occurrence of clinical events. Until then, clinical laboratories should rely on the existing procedures, which must be applied with caution and awareness of the many issues that may affect their results.




The following articles in journals at HighWire Press have cited this article:


Home page
 BloodHome page
B. Giannakopoulos, F. Passam, Y. Ioannou, and S. A. Krilis
How we diagnose the antiphospholipid syndrome
Blood, January 29, 2009; 113(5): 985 - 994.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Association for Clinical Chemistry.