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Update on the Laboratory Diagnosis of Lupus Anticoagulant: Current Challenges and Clinical Involvement

Title: Update on the Laboratory Diagnosis of Lupus Anticoagulant: Current Challenges and Clinical Involvement
Authors: Ana Marco-Rico
Source: Journal of Clinical Medicine ; Volume 14 ; Issue 8 ; Pages: 2791
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: lupus anticoagulant; antiphospholipid syndrome; preanalytical phase; dilute Russell’s viper venom test; silica clotting time; ratio; anticoagulation
Description: Lupus anticoagulant (LAC) is a heterogeneous mix of autoimmune antibodies that prolongs phospholipid-dependent clotting assays. Its diagnosis can be a real challenge in the hemostasis laboratory. In this review, the author describes the main pitfalls affecting the preanalytical phase and how to proceed to reduce interferences. Because of the heterogeneity of these autoantibodies, two assays with different mechanism of action should be performed to detect the majority of LACs. The dilute Russell’s viper venom test and the use of a reagent very sensitive to LAC derived from the activated partial thromboplastin time, using silica as the activator, are the most frequent techniques. The algorithms for LAC detection are reported here, and every laboratory is encouraged to introduce its own diagnostic procedure.Results should be expressed in ratio to reduce inter- and intravariability. In addition, the effect of anticoagulation in LAC assays and possible strategies for a correct diagnosis are provided.
Document Type: text
File Description: application/pdf
Language: English
Relation: Immunology; https://dx.doi.org/10.3390/jcm14082791
DOI: 10.3390/jcm14082791
Availability: https://doi.org/10.3390/jcm14082791
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.535B0512
Database: BASE