CoChat
Sign Up
Cited by 41Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsHeparin-Induced Thrombocytopenia and Thrombosis

Commonalities and contrasts in recent guidelines for lupus anticoagulant detection

Open access
Moore, G. W.·2014·International Journal of Laboratory Hematology
DOI 10.1111/ijlh.12227
Open this paper in CoChat — free accountOpen PDF

Abstract

Summary: Updates to guidelines covering lupus anticoagulant (LA) detection have recently been published by the International Society on Haemostasis and Thrombosis (ISTH) and British Committee for Standards in Haematology (BCSH), in 2009 and 2012, respectively. The Clinical and Laboratory Standards Institute (CLSI) published its first LA guideline in 2014. Cross‐panel agreement exists on sample manipulation, use of dRVVT analysis, conversion of clotting times to ratios, calculations to demonstrate phospholipid dependence, mixing test interpretation and provision of interpretive reporting. Whilst ISTH restricts assay choice to just dRVVT and activated partial thromboplastin time, BCSH and CLSI consider the case for additional tests. All panels acknowledge the potential for false‐negative mixing tests, yet they remain mandated by ISTH and BCSH, the latter, however, indicating that a negative mixing test need not exclude a LA if testing on undiluted plasma is unequivocal. CLSI reprioritizes test order to screen‐confirm‐mix to reduce false‐negative reporting when antibodies are diluted to undetectable levels in mixing tests. Recommendations differ on how to derive cut‐off levels, particularly in view of the realities of relatively low donor numbers. Each guideline considers testing of anticoagulated patients, BCSH and CLSI endorsing Taipan snake venom time as a useful supplementary assay in patients on vitamin K antagonists. Although full consensus is not apparent, these publications represent significant moves towards engendering common practices.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/ijlh.12227

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 26

  1. Keeling D, Mackie I, Moore GW, Greer IA, Greaves M; British Committee for Stan- dards in Haematology. Guidelines on the investigation and management of anti- phospholipid syndrome. Br J Haematol 2012;157:47-58.
  2. Ledford-Kraemer MR, Moore GW, Botte- nus R, Daniele C, de Groot PG, Exner T, Favaloro EJ, Moffat KA, Nichols WL. Labo- ratory Testing for the Lupus Anticoagulant. Approved guideline -first edition. CLSI document H60. Wayne, PA: Clinical and Laboratory Standards Institute; 2014 (in press).
  3. Wong RCW, Favaloro EJ. A consensus approach to the formulation of guidelines for laboratory testing and reporting of anti- phospholipid antibody assays. Semin Thromb Hemost 2008;34:361-72.
  4. Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus antico- agulants: an update. Thromb Haemost 1995;74:1185-90.
  5. Greaves M, Cohen H, Machin SJ, Mackie I. Guidelines on the investigation and man- agement of the antiphospholipid syndrome. Br J Haematol 2000;109:704-15.
  6. Moore GW. Clinical utility of the less com- monly employed assays for lupus anticoag- ulation detection: the evidence. J Coagul Disord 2010;2:69-79.
  7. Tripodi A. Laboratory testing for lupus anti- coagulants: a review of issues affecting results. Clin Chem 2007;53:1629-35.
  8. Lawrie AS, Mackie IJ, Purdy G, Machin SJ. The sensitivity and specificity of commer- cial reagents for the detection of lupus anti- coagulant show marked differences in performance between photo-optical and mechanical coagulometers. Thromb Hae- most 1999;81:758-62.
  9. Jennings I, Mackie I, Arnout J, Preston FE. Lupus anticoagulant testing using plasma spiked with monoclonal antibodies: perfor- mance in the UK NEQAS proficiency testing programme. J Thromb Haemost 2004;2:2178-84.
  10. Chantarangkul V, Tripodi A, Arbini A, Mannucci PM. Silica clotting time (SCT) as a screening and confirmatory test for the detection of the lupus anticoagulants. Thromb Res 1992;67:355-65.
  11. Kumano O, Ieko M, Naito S, Yoshida M, Takahashi N. APTT reagent with ellagic acid as activator shows adequate lupus anticoag- ulant sensitivity in comparison to silica- based reagent. J Thromb Haemost 2012;10:2338-43.
  12. Kershaw G, Suresh S, Orellana D, Nguy YM. Laboratory identification of lupus anti- coagulants. Semin Thromb Hemost 2012;38:375-84.
  13. Mackie IJ, Lawrie AS, Greenfield RS, Guin- to ER, Machin SJ. A new lupus anticoagu- lant test based on dilute prothrombin time. Thromb Res 2004;114:673-4.
  14. Devreese KMJ. Evaluation of a new com- mercial dilute prothrombin time in the diagnosis of lupus anticoagulants. Thromb Res 2008;123:404-11.
  15. Moore GW. Combining Taipan snake venom time/Ecarin time screening with the mixing studies of conventional assays increases detection rates of lupus anticoag- ulants in orally anticoagulated patients. Thromb J 2007;5:12.
  16. Moore GW, Smith MP, Patel Y, Savidge GF. The Activated Seven Lupus Anticoagulant (ASLA) assay: a new test for lupus antico- agulants (LAs). Evidence that some LAs are detectable only in extrinsic pathway based assays. Blood Coagul Fibrinolysis 2002;13:261-9.
  17. Moore GW, Brown KL, Bromidge ES, Drew AJ, Ledford-Kraemer MR. Lupus anticoagu- lant detection: out of control? Int J Haema- tol 2013;35:128-36.
  18. Gardiner C, Mackie IJ, Malia RG, Jones DW, Winter M, Leeming D, Taberner DA, Machin SJ, Greaves M. The importance of locally derived reference ranges and stan- dardised calculation of dilute Russell's Viper venom time results in screening for lupus anticoagulant. Br J Haematol 2000;111:1230-5.
  19. Horowitz GL, Altaie S, Boyd JC, Ceriotti F, Garg U, Horn P, Pesce A, Sine HE, Zakow- ski J. Defining, Establishing, and Verifying Reference Intervals in the Clinical Labora- tory. Approved Guideline -Third Edition. CLSI document C28-A3c. Wayne, PA: Clin- ical and Laboratory Standards Institute; 2008.
  20. Rosner E, Pauzner R, Lusky A, Modan M, Many A. Detection and quantitative evaluation of lupus circulating anticoagu- lant activity. Thromb Haemost 1987;57: 144-7.
  21. Male C, Lechner K, Speiser W, Pabinger I. Transient lupus anticoagulants in children: stepwise disappearance of diagnostic fea- tures. Thromb Haemost 2000;83:174-5.
  22. Reber G, Meijer P. In ECAT veritas? Lupus 2012;21:722-4.
  23. Jacobsen EM, Wisløff F. False negative screening tests for lupus anticoagulants - an unrecognised problem? Thromb Res 1996;82:445-51.
  24. Favaloro EJ, Bonar R, Zebeljan D, Kershaw G, Marsden K. Laboratory investigation of lupus anticoagulants: mixing studies are sometimes required. J Thromb Haemost 2010;8:2828-31.
  25. Tripodi A. To mix or not to mix in lupus anticoagulant testing? That is the question. Semin Thromb Hemost 2012;38:385-9.
  26. Tripodi A, Pengo V. More on: laboratory investigation of lupus anticoagulants: mix- ing studies are sometimes required. J Thromb Haemost 2010;8:2828-31.

Cited by

Sorted by citations

Authors
Moore, G. W.
Affiliations
St Thomas' Hospital (GB)
Corresponding author
Moore, G. W.
ORCID
Moore, G. W.
Venue
International Journal of Laboratory Hematology
Publisher
Wiley
Published
2014-04-18
Volume
36
Issue
3
Pages
364-373
ISSN
  • 1751-5521 (ISSN-L)
  • 1751-553X
DOI
10.1111/ijlh.12227
OpenAlex
W1992870465
Cited by
41
References
5
Citations by year
2025: 3 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 6 · 2016: 6 · 2015: 3
FWCI
0.82
Type
journal article
Language
en
Open access
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 › Surgery › Heparin-Induced Thrombocytopenia and Thrombosis
Keywords
lupus anticoagulant, dilute Russell's viper venom time, activated partial thromboplastin time, vitamin K antagonists, anticoagulated patients, cut-off values, phospholipid dependence, CLSI
MeSH terms
Blood Coagulation Tests, Humans, Reference Values, Reproducibility of Results, Lupus Coagulation Inhibitor, Practice Guidelines as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review