New guidelines for lupus anticoagulant: sensitivity and specificity of cut-off values calculated with plasmas from healthy controls in mixing and confirmatory tests
Abstract
Introduction The updated guidelines for lupus anticoagulant (LA) diagnosis indicate locally calculate the cut-off values of the index of circulating anticoagulant (ICA) and the clotting time in seconds (s) for mixing studies and % of correction (%C) for confirmatory tests. We assess sensitivity (SEN) and specificity (SPC) of the cut-off values obtained as the 99th percentile from 60 plasmas of healthy individuals. Methods We analysed 647 plasmas from patients studied in the last 3 years, and results were revaluated according to the new criteria and cut-off values. Four hundred and three had LA, and 75 of them were under oral anticoagulants (OA). We performed three screening tests: activated partial thromboplastin time (APTT), diluted Russell viper venom time (dRVVT) and dilute prothrombin time (dPT), and previous diagnosis was carried out using our home-made cut-off calculated by receiver operating characteristics curves. We reanalysed the mixing and confirmatory data of APTT/dRVVT, the tests selected in the new guidelines. To evaluate SPC, 244 plasmas (160 OA and 84 congenital deficient patients) were studied. Results Considering mixing studies, the cut-off values demonstrate that SEN of ICA-APTT was 94% and of clotting time in second (s) 83%, with an SPC of 77% and 84%, respectively. For ICA-dRVVT, SEN was 72% and for clotting time in second (s) 77%, with SPC of 98% and 84%, respectively. The cut-off values for %C for confirmatory APTT show good SEN 82% and high SPC 96%; fo…
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A previous study recommended the use of MTC for the dRVVT-based mixing test and ICA for the aPTT-based mixing test to achieve the highest sensitivity.
“a previous study recommended the use of MTC for the dRVVT-based mixing test and ICA for the aPTT-based mixing test to achieve the highest sensitivity [27].”
From Comparison of different algorithms for lupus anticoagulant detection: a single-center experience (2024) · cites this paper as [27]
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Update of the guidelines for lupus anticoagulant detection
PENGO, V., TRIPODI, A., REBER, G., RAND, J. H., ORTEL, T. L., GALLI, M., & DE GROOT, P. G. (2009) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2009.03555.x · Cited by 1,197 · see citing works
Brandt, J. T., Triplett, D. A., Alving, B., & Scharrer, I. (1995) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1649901 · Cited by 993 · see citing works
Galli, M., Luciani, D., Bertolini, G., & Barbui, T. (2003) · Blood · doi:10.1182/blood-2002-02-0441 · Cited by 974 · cited 1× · see citing works
“The laboratory detection of LA is very important because the higher association with thrombotic manifestations (Galli et al., 2003) which can implicate clinician’s treatment decision.”
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Antiphospholipid antibody testing and standardization
Devreese, K. M. J. (2014) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.12234 · Cited by 98 · see citing works
Moore, G. W., Culhane, A. P., Daw, C. R., Noronha, C. P., & Kumano, O. (2016) · Thrombosis Research · doi:10.1016/j.thromres.2016.01.019 · Cited by 42 · see citing works
Current Controversies in Lupus Anticoagulant Detection
Moore, G. (2016) · Antibodies · doi:10.3390/antib5040022 · Cited by 36 · see citing works
Kumano, O., Ieko, M., Naito, S., Yoshida, M., Takahashi, N., Suzuki, T., & Aoki, T. (2014) · Thrombosis Research · doi:10.1016/j.thromres.2014.05.030 · Cited by 15 · see citing works
Comparison of different algorithms for lupus anticoagulant detection: a single-center experience
Apipongrat, D., Lamool, R., Arnutti, P., Ruangpratheep, C., & Chantkran, W. (2024) · Research and Practice in Thrombosis and Haemostasis · doi:10.1016/j.rpth.2024.102333 · Cited by 4 · see citing works
- Authors
- MARTINUZZO, M. E., CERRATO, G. S., VARELA, M. L. I., ADAMCZUK, Y. P., & FORASTIERO, R. R.
- Affiliations
- Favaloro University (AR)
- Corresponding author
- MARTINUZZO, M. E.
- ORCID
- MARTINUZZO, M. E.
- Venue
- International Journal of Laboratory Hematology
- Publisher
- Wiley
- Published
- 2011-10-28
- Volume
- 34
- Issue
- 2
- Pages
- 208-213
- ISSN
- 1751-5521 (ISSN-L)
- 1751-553X
- OpenAlex
- W2131338115
- Cited by
- 16
- References
- 3
- Citations by year
- 2024: 1 · 2023: 2 · 2021: 1 · 2019: 1 · 2018: 1 · 2016: 4 · 2014: 2 · 2013: 4
- FWCI
- 1.40
- 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 › Surgery › Heparin-Induced Thrombocytopenia and Thrombosis
- Keywords
- lupus anticoagulant, diagnostic thresholds, sensitivity and specificity, mixing studies, confirmatory testing, activated partial thromboplastin time, clotting time, oral anticoagulants, inherited coagulation disorders, healthy controls
- MeSH terms
- Blood Coagulation Tests, Humans, Sensitivity and Specificity, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Practice Guidelines as Topic
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