Laboratory Testing For Lupus Anticoagulants. A Study From Tertiary Care Referral Centre
DOI:
https://doi.org/10.64149/J.Carcinog.24.3.175-186Keywords:
Lupus Anticoagulants (LA), Dilute Russell Viper Venom Time, Partial Thromboplastin Time, Antiphospholipid Syndrome, Systemic Lupus Erythematosus, Thrombotic Risk.Abstract
Background: Lupus anticoagulants (LA) are autoantibodies associated with an increased risk of thrombotic events, and their detection is crucial in the diagnosis of antiphospholipid syndrome (APS).
Aim and Objectives: The aim of this study is to analyze the referral patterns for Lupus Anticoagulant (LA) testing within our hospital, with a focus on evaluating and comparing the performance of Partial Thromboplastin Time-Lupus Anticoagulant (PTT-LA) and Dilute Russell’s Viper Venom Time (dRVVT) in detecting LA. Additionally, the study seeks to assess the role and optimal sequence of mixing studies within the testing algorithm, providing insights into refining diagnostic accuracy for Lupus Anticoagulant.
Methods: A total of 1,000 subjects were included in the study. The study employed tests such as the Dilute Russell Viper Venom Time (DRVVT) and Partial Thromboplastin Time-LA (PTT-LA) for screening and confirming the presence of lupus anticoagulants.
Results: The mean Prothrombin Time (PT) was 16.31 ± 8.77 seconds, Activated Partial Thromboplastin Time (APTT) was 34.13 ± 14.01 seconds, and Thrombin Time (TT) was 21.94 ± 30.50 seconds. Lupus anticoagulant testing revealed that 33.5% of patients were positive, 58.5% negative, and 8.0% probable positive. Among the positive cases, the DRVVT screening test had a sensitivity of 100% and a specificity of 67.0%, with an area under the ROC curve of 0.8176. The PTT-LA screening test showed a sensitivity of 70.8% and a specificity of 76.1%, with an area under the ROC curve of 0.7246. Statistically significant differences were observed in the end results based on ACL-IgM and β2 Glycoprotein-IgG tests (p < 0.05).
Conclusion: The DRVVT screening test demonstrated higher accuracy, sensitivity, and specificity compared to the PTT-LA screening test. The study concluded that DRVVT is a more reliable method for detecting lupus anticoagulants and predicting thrombotic risk in patients.
