PDF herunterladen
Thromb Haemost 1997; 77(02): 336-342
DOI: 10.1055/s-0038-1655965
Original Article
Schattauer GmbH Stuttgart

Evaluation of Sensitivity and Specificity of a Standardized Procedure Using Different Reagents for the Detection of Lupus Anticoagulants

J Goudemand
1   Laboratoire d’Hématologie, Hôpital Huriez, Lille
,
C Caron
1   Laboratoire d’Hématologie, Hôpital Huriez, Lille
,
D De Prost
2   Service d’Hématologie, Hôpital Bichat, Paris
,
A Derlon
3   Laboratoire d’Hématologie, CHRU Côte de Nacre, Caen
,
J Y Borg
4   Laboratoire d’Hématologie, Hôpital Charles Nicolle, Rouen
,
J Sampol
5   Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille
,
P Sié
6   Laboratoire d’Hématologie, Hôpital Purpan, Toulouse, France
,
for the Working Group on Hemostasis of the Société Française de Biologie Clinique and for the Groupe d’Etudes sur I’Hémostase et la Thrombose› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 31. Juli 1996

Accepted after revision 09. Oktober 1996

Publikationsdatum:
10. Juli 2018 (online)

Auch verfügbar auf
 als PDF herunterladen  Lizenzen und Reprints

Summary

This study was designed to test the sensitivity and specificity of a combination of 3 phospholipid-dependent assays performed with various reagents, for the detection of lupus anticoagulant (LA). Plasmas containing an LA (n = 56) or displaying various confounding pathologies [58 intrinsic pathway factor deficiencies, 9 factor VIII inhibitors, 28 plasmas from patients treated with an oral anticoagulant (OAC)] were selected. In a first step, the efficiency of each assay and reagent was assessed using the Receiving Operating Characteristic (ROC) method. Optimal cut-offs providing both sensitivity and specificity ≥80% were determined. The APTT assay and most of the phospholipid neutralization assays failed to discriminate factor VIII inhibitors from LA. In a second step, using the optimal cut-offs determined above, the results of all the possible combinations of the 3 assays performed with 4 different reagents were analyzed. Thirteen combinations of reagents allowed ≥ 80% of plasmas of each category (LA, factor deficiency or OAC) to be correctly classified (3/3 positive test results in LA-containing plasmas and 0/3 positive results in LA-negative samples).

 

  • References

  • 1 Mc NeilHP, Simpson RJ, Chesterman CN, Krilis SA. Antiphospholipid antibodies are directed against a complex antigen that includes a lipid-binding inhibitor of coagulation:β2-glycoprotein I (apolipoprotein H). Proc Natl Acad Sci USA 1990; 87: 4120-4124
    CrossrefPubMedSuche in Google Scholar
  • 2 Bevers EM, Galli M, Barbui T, Comfurius P, Zwaal RFA. Lupus anticoagulant IgG’s (LA) are not directed to phospholipids only but to a complex of lipid-bound human prothrombin. Thromb Haemost 1991; 66: 629-632
    Thieme ConnectPubMedSuche in Google Scholar
  • 3 Galli M, Comfurius P, Maasen C, Hemkers HC, De BaetsMH, van Breda-VriesmanPJC, Barbui T, Zwaal RFA, Bevers EM. Anticardiolipin antibodies (ACA) are directed not to cardiolipin but to a plasma protein cofactor. Lancet 1990; 335: 1544-1547
    CrossrefPubMedSuche in Google Scholar
  • 4 Triplett DA. Antiphospholipid-protein antibodies:laboratory detection and clinical relevance. Thromb Res 1995; 78: 01-31
    CrossrefPubMedSuche in Google Scholar
  • 5 Harris EN, Gharavi AE, Boey ML. Anticardiolipin antibodies:detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983; 02: 1211-1214
    PubMedSuche in Google Scholar
  • 6 Hughes GRV. Thrombosis, abortion, cerebral diseas and the lupus anticoagulant. Br Med J 1983; 287: 1088-1089
    CrossrefPubMedSuche in Google Scholar
  • 7 Hughes GRV. The antiphospholipid syndrome:ten years on. Lancet 1993; 343: 341-344
    PubMedSuche in Google Scholar
  • 8 Triplett DA. Antiphospholipid antibody syndromes. In: Hypercoagulable states. Fundamental aspects, acquired disorders and congenital thrombophilia Seghatchian MJ, Samama MM, Hecker SP. eds. CRC Press; Boca Raton, New York, London, Tokyo (PA): 1996. pp 223-232
    Suche in Google Scholar
  • 9 Exner T, Triplett DA, Taberner D, Machin SJ. Guidelines for testing and revised criteria for lupus anticoagulants. Thromb Haemost 1991; 65: 320-322
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants:an update. Thromb Haemost 1995; 74: 1185-1190
    Thieme ConnectPubMedSuche in Google Scholar
  • 11 Working group on Haemostasis of the SociétéFrangaise de Biologie Clinique. Comparison of a standardized procedure with current laboratory practices for the detection of lupus anticoagulant in France. Thromb Haemost 1993; 70: 781-786
    Thieme ConnectPubMedSuche in Google Scholar
  • 12 Adcock DM, Marlar RA. Activated partial thromboplastin time reagent sensitivity to the presence of lupus anticoagulants. Arch pathol Lab Med 1992; 116: 837-840
    PubMedSuche in Google Scholar
  • 13 Brandt JT, Triplett DA, Musgrave K, Orr CA. The sensitivity of different coagulation reagents to the presence of lupus anticoagulants. Arch Pathol Lab Med 1987; 111: 120-124
    PubMedSuche in Google Scholar
  • 14 Brandt JT, Barna LK, Triplett DA. Laboratory identification of lupus anticoagulants:results of the second international workshop for identification of lupus anticoagulants. On behalf of the Subcommittee on Lupus Anticoagulants/Antiphospholipid Antibodies of the ISTH. Thromb Haemost 1995; 74: 1597-1603
    Thieme ConnectPubMedSuche in Google Scholar
  • 15 Denis-Magdelaine A, Flahaud A, Verdy E. Sensitivity of sixteen reagents for the presence of lupus anticoagulants. Haemostasis 1995; 25: 98-105
    PubMedSuche in Google Scholar
  • 16 Kasper CK, Aledort LM, Counts RB, Edson JR, Frantantoni J, Green D, Hampton JW, Hilgartner MW, Lazerson J, Levine PH, Me MillanCW, Pool JG, Shapiro SS, Schulman NR, Van EysJ. A more uniform measurement of factor VIII inhibitors. Thromb Diath Haemorrh 1975; 34: 869-872
    PubMedSuche in Google Scholar
  • 17 Rosner E, Pauzner R, Lusky A, Modan M, Many A. Detection and quantitative evaluation of lupus circulating anticoagulant activity. Thromb Haemost 1987; 57: 144-147
    Thieme ConnectPubMedSuche in Google Scholar
  • 18 Rosove MH, Ismail M, Koziol BJ, Runge A, Kasper CK. Lupus anticoagulants:improved diagnosis with a kaolin clotting time using rabbit brain phospholipid in standard and high concentrations. Blood 1986; 68: 472-478
    PubMedSuche in Google Scholar
  • 19 Arnout J, Vanrusselt M, Huybrechts E, Vermylen J. Optimization of the dilute prothrombin time for the detection of the lupus anticoagulant by use of a recombinant tissue thromboplastin. Br J Haematol 1994; 87: 94-99
    CrossrefPubMedSuche in Google Scholar
  • 20 Forastiero RR, Cerrato GS, Carreras LO. Evaluation of recently described tests for the detection of the lupus anticoagulant. Thromb Haemost 1994; 72: 728-733
    Thieme ConnectPubMedSuche in Google Scholar
  • 21 Jaeger U, Kapiotis S, Pablinger I, Puchhammer E, Kyrle P, Lechner K. Transient lupus anticoagulant associated with hypoprothrombinaemia and factor XII deficiency following adenovirus infection. Annals Haematol 1993; 67: 95-99
    PubMedSuche in Google Scholar
  • 22 Endo Y. Congenital factor XII deficiency and lupus anticoagulant. Intern Med 1994; 33: 188
    CrossrefPubMedSuche in Google Scholar
  • 23 Brookfield C, Malia RG, Cooper SM, Greaves M. Factor XII levels and the lupus anticoagulant. Thromb Haemost 1995; 73: 1441
    PubMedSuche in Google Scholar
  • 24 Jones DW, Gallimore MJ, Winter M. Pseudo factor XII deficiency and phospholipid antibodies. Thromb Haemost 1996; 75: 693-697
    Thieme ConnectPubMedSuche in Google Scholar
  • 25 Kasper GK. Laboratory tests for factor VIII inhibitors, their variation, signification and interpretation. Blood Coag Fibrinol 1991; 2 (Suppl. 01) 07-10
    CrossrefPubMedSuche in Google Scholar
  • 26 Triplett DA, Bama LK, Unger GA. A hexagonal (II) phase phospholipid neutralization assay for lupus anticoagulant identification. Thromb Haemost 1993; 70: 787-793
    Thieme ConnectPubMedSuche in Google Scholar
  • 27 Exner T, Rickard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulants and its behavioral patterns. Br J Haematol 1978; 40: 143-151
    CrossrefPubMedSuche in Google Scholar
  • 28 Thiagarajan P, Pengo V, Shapiro S. The use of dilute Russel viper venom time for the diagnosis of lupus anticoagulants. Blood 1986; 68: 869-874
    PubMedSuche in Google Scholar
  • 29 Triplett DA, Stocker KF, Unger GA, Bama UK. The Textarin/Ecarin ratio:a confirmatory test for lupus anticoagulants. Thromb Haemost 1993; 70: 925-932
    Thieme ConnectPubMedSuche in Google Scholar
  • 30 Rooney AM, Mc NallyT, Mackie IJ, Machin SJ. The Taipan snake venom time:a new test for lupus anticoagulant. J Clin Pathol 1994; 47: 497-501
    CrossrefPubMedSuche in Google Scholar
  • 31 Galli M, Bevers EM, Comfurius P, Barbui T, Zwaal RF. Effect of antiphospholipid antibodies on procoagulant activity of activated platelets and platelet derived micro vesicles. Br J Haematol 1993; 83: 466-472
    CrossrefPubMedSuche in Google Scholar
  • 32 Galli M, Finazzi G, Bevers EM, Barbui T. Kaolin clotting time and dilute Russel’s viper venom time distinguish between prothrombin-dependent and β2-Glycoprotein I-dependent antiphospholipid antibodies. Blood 1995; 86: 617-623
    PubMedSuche in Google Scholar