Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: Update of the guidelines for lupus anticoagulant detection and interpretation.

Autor: Devreese KMJ; Coagulation Laboratory, Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.; Department of Diagnostic Sciences, Ghent University, Ghent, Belgium., de Groot PG; Synapse Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands., de Laat B; Synapse Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands., Erkan D; Barbara Volcker Center for Women and Rheumatic Diseases, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, USA., Favaloro EJ; Department of Haematology, Sydney Centres for Thrombosis and Haemostasis, Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia., Mackie I; Haemostasis Research Unit, Research Haematology Department, University College London, London, UK., Martinuzzo M; Laboratorio Central del Hospital Italiano de Buenos Aires, Departamento de Bioquímica Aplicada, Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina., Ortel TL; Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.; Department of Pathology, Duke University Medical Center, Durham, NC, USA., Pengo V; Thrombosis Research Laboratory, Department of Cardio-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy., Rand JH; Department of Pathology & Laboratory Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA., Tripodi A; Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Cà Granda Maggiore Policlinico Hospital Foundation, Milano, Italy.; Fondazione Luigi Villa, Milano, Italy., Wahl D; Vascular Medicine Division and Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy University Hospital, Nancy, France.; INSERM UMR-S 1116, University of Lorraine, Nancy, France., Cohen H; Haemostasis Research Unit, Department of Haematology, University College London, London, UK.; Department of Haematology, University College London Hospitals NHS Foundation Trust, London, UK.
Jazyk: angličtina
Zdroj: Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2020 Nov; Vol. 18 (11), pp. 2828-2839.
DOI: 10.1111/jth.15047
Abstrakt: 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 more information on the coagulation background of the patient, and when necessary, anti-Xa activity measurement for heparins or specific assays for direct oral anticoagulants should be performed. The three-step procedure with two test systems (diluted Russell's viper venom time and activated partial thromboplastin time [aPTT]) is essentially not changed. Silica remains the preferable activator in the aPTT assays, but ellagic acid is not excluded. We advise simultaneous performance of the mixing and confirmatory step, in each sample with a prolonged screening test. The confirmatory step can also be performed on a mixture of patient plasma and normal pooled plasma. Cutoff values should be established in-house on at least 120 normals, with transference of the manufacturer's cutoffs as an alternative. Reporting of results has not been changed, although more attention is focused on what clinicians should know. Patient selection for LA testing has been expanded.
(© 2020 International Society on Thrombosis and Haemostasis.)
Databáze: MEDLINE