Mixing studies for lupus anticoagulant: mostly yes, sometimes no
Open accessAbstract
Lupus anticoagulants (LAs) represent one manifestation of the clinical condition called antiphospholipid syndrome (APS) and are associated with many adverse clinical outcomes, but primarily with thrombosis and/or pregnancy morbidity. LAs are identified by laboratory testing, principally using clot-based assays based on Russell viper venom time (RVVT) and activated partial thromboplastin time (APTT) test methods. All three of the most recent guidance documents for LA testing recommend using these tests, although they vary in regard to inclusion/exclusion of other test processes. Mixing studies form part of the process of LA identification/exclusion, since in vitro LAs act like coagulation inhibitors. Mixing studies are also supported by all three LA guidance documents, but recommendations vary in regard to relative importance and placement in the LA identification/exclusion algorithm. This Point article takes the position that mixing tests are usually indicated for appropriate identification/exclusion of LAs, but can occasionally be omitted.
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- Authors
- Favaloro, E.
- Affiliations
- Westmead Hospital (AU)
- Corresponding author
- Favaloro, Emmanuel
- ORCID
- Favaloro, Emmanuel
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2019-12-24
- Volume
- 58
- Issue
- 4
- Pages
- 487-491
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W2998426955
- Cited by
- 20
- References
- 19
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 6 · 2022: 5 · 2020: 3
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Charles Sturt University Research Output (CRO) (submittedVersion, other-oa)
- 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, mixing studies, antiphospholipid syndrome, activated partial thromboplastin time, anticoagulants, thrombosis, pregnancy morbidity
- MeSH terms
- Anticoagulants, False Positive Reactions, Humans, Partial Thromboplastin Time, Prothrombin Time, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Guidelines as Topic
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