Frequent False‐positive results of lupus anticoagulant tests in plasmas of patients receiving the new oral anticoagulants and enoxaparin
Abstract
Introduction Oral direct thrombin and Xa inhibitors are worldwide distributed for prevention and treatment of thrombosis. It is important to recognize their effects on lupus anticoagulant (LA) testing. The aim of the study is to describe the rate of false-positive results of LA tests on plasmas of patients with previous negative LA tests results that receive dabigatran etexilate (DAB) 110 mg/twice a day, rivaroxaban (RIV) 10 mg/day or 15 mg/twice a day, or enoxaparin 40 mg/day. Methods Blood was taken between 1.5 and 4 h post administration. Tests evaluated are as follows: prothrombin time, APTT, dilute Russell viper venom time (DRVVT) screen, APTT, and DRVVT mixing studies, index of circulating anticoagulant (ICA) with normal plasma, screen/confirm normalized ratio (NR) for DRVVT and silica clotting time (SCT). Results Plasmas from patients taking DAB (n = 22) presented 100% prolonged APTT and DRVVT with ICA above the cutoff point and 81.8% positive screen/confirm NR, 100% prolonged SCT screen, but 4.5% positive confirmatory NR. All patients receiving RIV at 15 mg/twice a day (n = 4) presented positive DRVVT screen, mixing, and confirmatory tests, 75% and 100% prolonged APTT and SCT screen, with negative screen/confirm NR. Those taking RIV 10 mg/day (n = 22) showed 81.8% prolonged DRVVT screen, 82.3% and 76.5% of them with positive mixing and confirmatory studies. Patients receiving enoxaparin also presented high prevalence of APTT and DRVVT false-positive results. Conclusio…
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In situations where alternative or co-existing coagulation abnormalities are present, mixing tests can improve specificity of LA testing.
“However, in situations where alternative or co‐existing coagulation abnormalities are present, mixing tests can improve specificity of LA testing.34, 35, 36, 37”
False positives have been described for aPTT and dRVVT even when utilizing heparin neutralizers.
“False positives have been described for aPTT and dRVVT even when utilizing neutralizers [68,69,70].”
From Lupus Anticoagulant Detection under the Magnifying Glass (2023) · cites this paper as [69]
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Dilute Russell's viper venom time reagents in lupus anticoagulant testing: a well‐considered choice
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Lupus Anticoagulant Detection under the Magnifying Glass
Molinari, A. C., Martini, T., Banov, L., Ierardi, A., Leotta, M., Strangio, A., & Santoro, R. C. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206654 · Cited by 9 · see citing works
Analytical dilemmas in lupus anticoagulant detection
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- Authors
- Martinuzzo, M. E., Barrera, L. H., D 'Adamo, M. A., Otaso, J. C., Gimenez, M. I., & Oyhamburu, J.
- Affiliations
- Hospital Italiano de Buenos Aires (AR)
- Grupo Bioquímico Laboratorio Central Hospital Italiano de Buenos Aires CABA Argentina
- Corresponding author
- Martinuzzo, M. E.
- Venue
- International Journal of Laboratory Hematology
- Publisher
- Wiley
- Published
- 2013-09-06
- Volume
- 36
- Issue
- 2
- Pages
- 144-150
- ISSN
- 1751-5521 (ISSN-L)
- 1751-553X
- OpenAlex
- W1977286952
- Cited by
- 91
- References
- 1
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 9 · 2022: 3 · 2021: 8 · 2020: 10 · 2019: 7 · 2018: 10 · 2017: 11 · 2016: 13 · 2015: 6 · 2014: 7
- FWCI
- 7.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- International Journal of Laboratory Hematology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- lupus anticoagulant, false positives, direct oral anticoagulants, dabigatran etexilate, rivaroxaban, enoxaparin, direct thrombin inhibitors, factor Xa inhibitors, dilute Russell viper venom time, activated partial thromboplastin time, thromboprophylaxis
- MeSH terms
- Administration, Oral, Anticoagulants, False Positive Reactions, Female, Hematologic Tests, Humans, Male, Reference Values, Lupus Coagulation Inhibitor, Enoxaparin, Venous Thromboembolism
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