Dilute Russell’s viper venom time reagents in lupus anticoagulant testing: a well-considered choice

Depreter, Barbara; Devreese, Katrien

doi:10.1515/cclm-2016-0245

Cited by 26 publications

(50 citation statements)

References 37 publications

(36 reference statements)

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“…However, information on the confirmatory test, even if the mixing step is negative, can help in the interpretation. 34,35,58 On the other hand, mixing tests add information on the results of screening and confirmatory testing, especially in anticoagulated patient samples. 35 We recommend that a final conclusion on possible interferences and the potential need for retesting (see more at "Interpretation of Results and Report") is provided.…”

Section: Three Step Proceduresmentioning

confidence: 99%

“…The 2009 ISTH‐SSC guidelines advocate performing the mixing step after finding a prolonged screening test, and if the mixing test suggests LA presence, performance of a confirmatory test 12 . However, information on the confirmatory test, even if the mixing step is negative, can help in the interpretation 34,35,58 . On the other hand, mixing tests add information on the results of screening and confirmatory testing, especially in anticoagulated patient samples 35 .…”

Section: Preanalytical Analytical and Postanalytical Factors In La Tmentioning

confidence: 99%

See 1 more Smart Citation

Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis

Devreese

Groot

Laat

et al. 2020

Journal of Thrombosis and Haemostasis

259

457

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This guidance focuses on methodological aspects of lupus anticoagulant (LA) testing, as well as interpretation of results for clinicians. The main changes in how to test for LA compared with the International Society on Thrombosis and Haemostasis Scientific and Standardization Committee 2009 guidelines, in the preanalytical phase are more detailed recommendations on how to handle testing in anticoagulated patients, and the timing of testing. Also, routine coagulation tests are advised to obtain | 2829 DEVREESE Et al.

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Section: Three Step Proceduresmentioning

confidence: 99%

Section: Preanalytical Analytical and Postanalytical Factors In La Tmentioning

confidence: 99%

Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis

Devreese

Groot

Laat

et al. 2020

Journal of Thrombosis and Haemostasis

259

457

View full text Add to dashboard Cite

show abstract

“…Ideally, LA testing should not be performed in patients using anticoagulants as anticoagulants usually cause prolonged clotting times, which may increase the risk of erroneous interpretation. [28][29][30] It could be argued that samples from warfarin-treated patients should be excluded, especially as neither mixing test results nor cutoff especially for these patients were evaluated. In addition, the group of warfarin-treated patients are few; thus, it cannot be drawn firm conclusions regarding reclassifications.…”

Section: Strength and Limitationsmentioning

confidence: 99%

Impact of different preanalytical conditions on results of lupus anticoagulant tests

Kristoffersen

Hammer

Vannes

et al. 2019

Int J Lab Hematology

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Introduction:The currently recommended preanalytical conditions for lupus anticoagulant (LA) analysis require analyzing samples in fresh or freshly frozen platelet-poor plasma. The aim of this study was to evaluate whether alternative and less cumbersome preanalytical procedures for LA testing give significantly different results compared to recommended conditions. Materials and Methods: Citrated blood samples were drawn from 29 study participants, 15 with negative and 14 with positive LA results. The samples were processed according to the ISTH guideline for LA testing and compared to several alternative preanalytical conditions. Measurements were performed using the dilute Russell's viper venom time (DRVVT) and silica clotting time (SCT), both screen and confirm, on a STA-R Evolution analyzer. Stability criteria were based upon biological variation.Results: All DRVVT tests (normalized screen, confirm, and screen/confirm ratio) met the stability criteria for all the preanalytical conditions. The SCT tests (normalized screen, confirm, and screen/confirm ratio) met the stability criteria only when treated according to the ISTH guideline, except for SCT normalized screen/confirm ratio which also met the stability criteria for double-centrifuged aliquoted plasma stored in room temperature for 24 hours and then analyzed "fresh" or after being frozen. One warfarin-treated patient was reclassified from positive to negative for DRVVT after the preanalytical modifications, while 2 of 29 participants became falsely positive for 2 of 8 conditions for SCT. Conclusions:The DRVVT assays met the criteria for stability for all preanalytical conditions tested, while the SCT assays should be interpreted with caution if the preanalytical guidelines from ISTH are not followed. K E Y W O R D S dilute Russell's viper venom time, lupus anticoagulant, preanalytical conditions, silica clotting time, stability

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“…19 Recently, newly developed dRVVT reagents were reported to exhibit improved specificity as a result of less discordance between screens and to confirm results in samples from patients anticoagulated with vitamin K antagonists and direct oral anticoagulants. 18,20 The dRVVT reagents used in the present study were affected by warfarin because the median percent correction in the warfarin group was similar to that of the dRVVT/dAPTT positive group and it was considered that LA1/LA2 showed a high false positive rate with these patients (Figure 1). According to earlier BSH guidelines, we adopted 10% as the cut-off value in percent correction for Cephen LS/Cephen assay in the present study.…”

Section: Discussionmentioning

confidence: 94%

“…16,17 Depreter and Devreese 18 previously reported that clotting times with dRVVT screening and confirmation reagents were prolonged for moderately decreased FII and FX levels (40%-60%) and mildly decreased FV (70%). 18 In the present study, percent correction was calculated in FII, FV and FX deficient samples. The percent correction value ranges of FII <5% and FV <2% with high screen ratios were 11.7-19.…”

Section: Discussionmentioning

confidence: 99%

Paired APTTs of low and high lupus anticoagulant sensitivity permit distinction from other abnormalities and achieve good lupus anticoagulant detection rates in conjunction with dRVVT

Kumano

Amiral²,

Dunois³

et al. 2018

Int J Lab Hematology

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Introduction A prolonged activated partial thromboplastin time (APTT) may be indicative of a specific or multiple factor deficiency, therapeutic anticoagulation, presence of a nonspecific factor inhibitor, or lupus anticoagulant (LA). Recently, pairing of the LA‐sensitive APTT and standard APTT reagents, Cephen LS and Cephen, respectively, has been shown to be effective in LA detection. The present study aimed to evaluate the usefulness of this reagent pair for discriminating between causes of APTT elevation and the detection of LA in conjunction with dilute Russell's viper venom time (dRVVT). Methods Plasma samples from 50 normal and 105 non‐anticoagulated LA‐positive patients in routine dRVVT and/or dilute APTT (dAPTT) via the percent correction formula were employed. Cephen LS/Cephen and dRVVT reagents LA1/LA2 were used to screen/confirm, respectively. Thirty‐four symptomatic LA‐negative, 25 warfarinised non‐antiphospholipid syndrome, 6 coagulation inhibitors, 17 samples with hereditary elevated APTT, and 24 FVIII/IX/XI/XII and 17 FII/V/X artificial single deficiency plasmas were used. Results Thirty‐three samples out of 105 (31%) were LA‐positive in Cephen LS/Cephen. The total percent positivity in Cephen LS/Cephen and LA1/LA2 pairs was 89.1% against samples with the routine dRVVT/dAPTT double positive. The percent corrections of Cephen LS/Cephen in the routine dAPTT/dRVVT positive group were significantly higher than those in all other groups. Conclusions The percent correction of the APTT reagent pair showed higher values in LA‐positive samples. The combination will be useful with respect to differentiating LA from other abnormal samples and is effective in LA detection when paired with dRVVT.

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Dilute Russell’s viper venom time reagents in lupus anticoagulant testing: a well-considered choice

Abstract: dRVVT reagents differ in LAC sensitivity and for VKA and DOAC interference.

Cited by 26 publications

References 37 publications

Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis

Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis

Impact of different preanalytical conditions on results of lupus anticoagulant tests

Paired APTTs of low and high lupus anticoagulant sensitivity permit distinction from other abnormalities and achieve good lupus anticoagulant detection rates in conjunction with dRVVT

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