Thromb Haemost 1987; 57(02): 144-147
DOI: 10.1055/s-0038-1651083
Original Article
Schattauer GmbH Stuttgart

Detection and Quantitative Evaluation of Lupus Circulating Anticoagulant Activity

Esther Rosner
*   The Institute of Hematology, the Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel
,
Rachel Pauzner
*   The Institute of Hematology, the Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel
,
Ayala Lusky
**   The Department of Epidemiology, the Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel
,
Michaela Modan
**   The Department of Epidemiology, the Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel
,
Amira Many
*   The Institute of Hematology, the Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel
› Author Affiliations
Further Information

Publication History

Received 15 July 1986

Accepted after revision 12 December 1986

Publication Date:
28 June 2018 (online)

Summary

Sixty-six SLE patients were studied for the presence of lupus type circulating anticoagulant. Forty-nine percent of them showed activity of this anticoagulant. The sensitivity of various coagulation tests was compared. Recalcification time was found to be the most sensitive screening test and the kaolin clotting time mixture test, the best for determining the presence of the anticoagulant.

Tissue thromboplastin inhibition test detected only half of the patients in whom the anticoagulant was found by recalcification time and kaolin clotting time mixture test.

APTT, using 2 different reagents, resulted in 73% and 52% false negatives. A numerical index for determining the presence of the anticoagulant and its quantitative evaluation is suggested.

The association between thromboembolic events, recurrent abortions and the different coagulation tests is shown.

 
  • References

  • 1 Mueh JR, Herbst KD, Rapaport SI. Thrombosis in patients with lupus anticoagulant. Ann Int Med 1980; 921: 156-159
  • 2 Firkin BG, Howard MA, Radford N. Possible relationship between lupus inhibitor and recurrent abortion in young women. Lancet 1980; 2 I 366
  • 3 Mannucci PM, Canciani MT, Mari D, Meucci P. The varied sensitivity of partial thromboplastin and prothrombin time reagents in demonstration of the lupus like anticoagulant. Scand J Haematol 1979; 22: 423-432
  • 4 Stem W, MacDonald VE. Factors affecting the sensitivity of APTT reagents to lupus inhibitors. Thromb & Haemost Xth International Congress on Thrombosis and Haemostasis, 1985; July 14th, Abst No. 680
  • 5 Mohammad SF, Martin BA, Hershgold EJ. The importance of reagents in the laboratory detection of lupus anticoagulants. Thromb & Haemost Xth International Congress on Thrombosis and Haemostasis, 1985; July 14th, Abst No. 488
  • 6 Margolis J. The kaolin clotting time: A rapid one stage method for diagnosis of coagulation defects. J Clin Pathol 1958; II: 406-409
  • 7 Exner T, Richard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulants and its behavioral patterns. Brit J Haematol 1978; 40: 143-151
  • 8 Schleider MA, Nachman RL, Jaffe EA, Coleman M. A clinical study of the lupus anticoagulant. Blood 1976; 48: 499-509
  • 9 Tan AM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester J. The 1982 revised criteria for the classification of SLE. Arthritis Rheum 1982; 25: 1271-1277
  • 10 Pauzner R, Rosner E, Many A. Circulating anticoagulant in SLE: Clinical manifestations. Acta Haematol. (in press)
  • 11 Triplett DA, Brandt JT, Kaczor D, Schaffer JS. 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 (06) 678-682
  • 12 Byron MA. The clotting defect in SLE. Clin Rheum Dis 1982; 8 (01) 137-151
  • 13 Kelsey PR, Stevenson KJ, Poller L. The diagnosis of lupus anticoagulants by the activated partial thromboplastin time - the central role of phosphatidyl serine. Thromb Haemostas 1984; 52: 172-175
  • 14 Shapiro SS, Thiagarajan P. Lupus anticoagulants. Prog Haemos and Thromb 1982; 6: 263-285
  • 15 Gladman DD, Urowitz MB, Tozman EG, Glynn FX. Haemostatic abnormalities in SLE. Quart J Med 1983; 207: 424-433
  • 16 Boey ML, Colaco CB, Gharavi AE, Loizu S, Hughes G RV. Thrombosis in SLE: Striking association with the presence of circulating lupus anticoagulant. Brit Med J 1983; 287: 1021-1023
  • 17 Elias M, Eldor A. Thromboembolism in patients with lupus type circulating anticoagulant. Arch Intern Med 1984; 144: 510-518
  • 18 Hughes G RV. Thrombosis, abortion, cerebral disease and the lupus anticoagulant. Brit Med J 1983; 287: 1088-1089