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Cited by 13Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsClinical Laboratory Practices and Quality Control

Diagnostic analysis of lupus anticoagulant using clot waveform analysis in activated partial thromboplastin time prolonged cases: A retrospective analysis

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Kanouchi, Kazunori, Narimatsu, Hiroto, Shirata, Toru, Morikane, Keita·2021·Health Science Reports
DOI 10.1002/hsr2.258PMC PMC7953360
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Abstract

Background and Aims: Hemophilia was diagnosed in precedence research of clot waveform analysis (CWA) using the activated partial thromboplastin time (APTT). In patients with antiphospholipid syndrome (APS), lupus anticoagulant (LA) causes an increase in APTT, suggesting that the waveform would probably be distorted. Therefore, we evaluated using clinical samples. CWA may be useful low cost for clinical detection of LA. We assessed the clinical value of CWA for detection of LA and coagulation using clinical blood samples collected from patients with a prolonged APTT. Methods: We used patient samples inspected between April 2011 and March 2013 in Yamagata University Hospital. CWA was performed using the ACL TOP coagulation analyzer, and the associated software program was used to calculate APTT clotting endpoints. An atypical peak was defined as a derivative plot that did not conform to the normal S‐shaped clot reaction curve. Results: In total, 162 patients, including 66 men and 96 women, with an average age of 46 years (range: 24‐89 years) were included. We also collected control samples from unmatched healthy donors. All 162 patients were divided according to medication history or condition into the following five groups: heparin (n = 20), warfarin (n = 23), hepatic dysfunction (n = 13), normal (n = 20), and LA‐positive antiphospholipid syndrome (APS; n = 86). Twenty healthy individuals were included as controls. Eighty patients had an atypical peak. Among all, 78 patients (90.6%) were LA‐positive, and 2 patients (2.5%) were treated with warfarin. The remaining two patients had prothrombin time international normalized ratios (PT‐INR) >4.0 while taking warfarin. Those who were APS LA positive with thrombosis and without thrombosis had split the reaction of clotting time, deceleration/acceleration time (D/A) ratio of 2.36 (1.99,3.24) vs 2.34 (2.04,2.86), respectively. Conclusion: The significant atypical peak and D/A ratio extension may be explained by the clotting waveforms observed specifically in patients with LA‐positive APS.

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  • Clot waveform analysis (CWA) is little used in laboratories and its clinical utility is still being evaluated.

    “However, it is little used in laboratories and its clinical utility is still being evaluated [41].”

    From Lupus Anticoagulant Detection under the Magnifying Glass (2023) · cites this paper as [41]

    The Introduction (page not provided) says the authors assessed CWA’s clinical value for detecting lupus anticoagulant, and the Discussion calls for further studies using other analyzers. This supports the claim that its clinical utility is still being evaluated, but our copy does not say CWA is little used in laboratories. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 22

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Cited by

Sorted by citations

Authors
Kanouchi, K., Narimatsu, H., Shirata, T., & Morikane, K.
Affiliations
  • Yamagata University Hospital (JP)
  • Kanagawa Cancer Center (JP)
Corresponding author
Narimatsu, Hiroto
ORCID
Venue
Health Science Reports
Publisher
Wiley
Published
2021-03-12
Volume
4
Issue
2
Pages
e258-e258
ISSN
2398-8835 (ISSN-L)
DOI
10.1002/hsr2.258
PMC
PMC7953360
OpenAlex
W3136420224
Cited by
13
References
2
Citations by year
2026: 4 · 2025: 4 · 2023: 3 · 2022: 1 · 2021: 1
FWCI
0.94
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Science Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Keywords
lupus anticoagulant, clot waveform analysis, antiphospholipid syndrome, activated partial thromboplastin time, prolonged aPTT, warfarin, heparin, thrombosis, coagulation tests

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