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Letters to the Editor |
1 Department of Haematology, and Transfusion Medicine, Royal North Shore Hospital, Sydney, 2065, Australi
2 Northern Blood Research Centre, University of Sydney, RNSH campus, Sydney, Australia
3 Pacific Laboratory, Medicine Services, Royal North Shore Hospital, Sydney, Australia
aAddress correspondence to this author at: PaLMS Haematology, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia. Fax 612-9926-6066; e-mail maboud@nsccahs.health.nsw.gov.au.
| The first 20% of the full text of this article appears below. |
To the Editor:
The recommended (1) step-wise approach to the study of lupus anticoagulant (LA) begins with a prolonged clotting time in a phospholipid-dependent clotting assay (screen), a noncorrection in a mix with pooled normal plasma (PNP), and then a correction in the presence of increased phospholipid (confirm). Laboratories differ in their application of these recommendations. Jacobsen et al.(2) integrate screen, mix, and confirm into a single assay and analyze the data as a lupus ratio (LR). Tripodi et al.(3) propose no prior mix with PNP even for patients on oral anticoagulant (OAC) and analyze their data as a percentage correction. We wished to compare these 2 approaches by using the common(4) dilute Russell viper venom test (dRVVT) as the clotting assay.
Samples were collected from 500 consecutive patients (291 women, median age 56 years) for whom LA tests were requested during a 5-month period. Repeat tests (n = 19) were excluded on
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