Solvent Extraction of Test Plasmas for Improved Recovery of Lupus Anticoagulant Activity

Summary

Phospholipid procoagulant material mainly derived from platelets interferes or “bypasses” the more specific tests for lupus anticoagulants. Such material in test plasmas can be inactivated with recovery of lupus anticoagulant activity by simple extraction with chloroform. This solvent treatment damages mainly factors VIII, V, VII and IX. Ether and various other solvents were less damaging to these clotting factors but not quite as effective as chloroform in the recovery of lupus anticoagulant activity.

• References

• 1 Firkin BG, Booth P, Hendrix L, Howard MA. Demonstration of a platelet bypass mechanism in the clotting system using an acquired anticoagulant. Hematology 1978; 5: 81-92
• 2 Exner T. Comparison of two simple tests for the lupus anticoagulant. Am J Clin Pathol 1983; 83: 215-218
• 3 Wolf P. The nature and significance of platelet products in human plasma. Br J Haematol 1967; 13: 269-288
• 4 Howard MA, Coghlan M, David R, Pfueller SL. Coagulation activities of plasma microparticles. Thromb Res 1988; 50: 145-156
• 5 Exner T, Triplett DA, Tabemer DA. et al Recommendations of the Working Party for Standardization of the Lupus Anticoagulant. Thromb Haemostas 1990. in press
• 6 Exner T, Rickard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulant and its behavioural patterns. Br J Haematol 1978; 40: 143-51
• 7 Quick AJ. The prothrombin in haemophilia and in obstructive jaundice. J Biol Chem 1935; 109: 73-74
• 8 Proctor RR, Rapaport SI. The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. Am J Clin Pathol 1961; 36: 212-219
• 9 Margolis J. The kaolin clotting time. A rapid one stage method for diagnosis of coagulation defects. J Clin Pathol 1958; 11: 406-409
• 10 Exner T, Papadopoulos G, Koutts J. Use of a simplified dilute Russell’s viper venom time (DRWT) confirms heterogeneity among “lupus” anticoagulants. Blood Coagul Fibrinolys 1990. in press
• 11 Schleider MA, Nachman RL, Jaffe EA, Coleman M. A clinical study of the lupus anticoagulant. Blood 1976; 48: 449-509
• 12 Bell HG, Alton HG. A brain extract as a substitute for platelet suspensions in the thromboplastin generation test. Nature 1954; 174: 880-881
• 13 Triplett DA, Brandt JT, Kaczor D, Schaefer J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. Am J Clin Pathol 1983; 79: 678-682
• 14 Exner T. Similar mechanisms of various lupus anticoagulants. Thromb Haemostas 1988; 53: 15-18
• 15 Lesperance B, David M, Rauch J, Infante-Rivard C, Rivard GE. Relative sensitivity of different tests in the detection of low titer lupus anticoagulants. Thromb Haemostas 1988; 60: 217-219
• 16 Lo S CL, Oldmeadow MJ, Howard MA, Firkin BG. Comparison of laboratory tests used for identification of the lupus anticoagulant. Am J Hematol 1989; 30: 213-220
• 17 Pengo V, Thiagarajan P, Shapiro SS, Heine MJ. Immunological specificity and mechanism of action of IgG lupus anticoagulants. Blood 1987; 70: 69-76
• 18 Tate G, Scott JS. Detection of lupus anticoagulant in stored serum. Lancet 1984; ii: 587