Utility of Lupus Anticoagulant Assays (APTT-LA, KCT, DPT and DRVVT) in Detection of Antiphospholipid Syndrome (APS) in High Risk Pregnancy Cases.
APTT-LA
Antiphospholipid syndrome
DRVVT
High risk pregnancy
KCT
Lupus anticoagulant
Recurrent abortions
dPT
Journal
Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion
ISSN: 0971-4502
Titre abrégé: Indian J Hematol Blood Transfus
Pays: India
ID NLM: 9425818
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
15
02
2018
accepted:
29
12
2018
entrez:
8
8
2019
pubmed:
8
8
2019
medline:
8
8
2019
Statut:
ppublish
Résumé
Routine investigation for recurrent pregnancy loss includes measurement of antiphospholipid antibodies. The lupus anticoagulant has long been associated with increased risks for thrombosis and adverse obstetric outcomes. But there are some disadvantages with lupus anticoagulant (LAC) tests which includes varied sensitivity of different clot based assays. ISTH recommends only 2 assays (preferably DRVVT and APTT-LA) for the identification of lupus anticoagulant but there are some studies which don't support this contention. Our study analyzed 526 samples from high risk pregnancy cases for APLA by all four LAC tests from tertiary centre of northern India. Among all the cases studies 65 cases were positive for lupus anticoagulant 25 of this became negative after 12 weeks. Among the 40 repeated positive assays, dRVVT could able to diagnose 36 cases followed by APTT-LA which could able to diagnose 28 cases, while KCT could able to diagnose 23 cases and dPT could able to diagnose only 14 cases. There were 12 cases in whom all lupus assays were positive. Our study thus concluded that DRVVT was the most sensitive followed by APPT-LA, KCT, dPT. The combination of dRVVT with APTT-LA or KCT appeared to be superior to other combinations. No individual test per se is 100% sensitive for the diagnosis of APLA in high risk pregnancy cases. Further results confirmed that repeated LAC result is required even in a high-risk setting. Positive LAC assay in majority were not associated with exclusively recurrent pregnancy loss but were associated with sporadic stillbirth and thrombosis.
Identifiants
pubmed: 31388260
doi: 10.1007/s12288-018-01072-8
pii: 1072
pmc: PMC6646618
doi:
Types de publication
Journal Article
Langues
eng
Pagination
478-484Déclaration de conflit d'intérêts
Conflict of interestThe authors declare that they have no conflict of interests.
Références
Thromb Haemost. 1999 Feb;81(2):256-8
pubmed: 10064002
Arthritis Rheum. 1999 Jul;42(7):1309-11
pubmed: 10403256
Int J Gynaecol Obstet. 2001 Nov;75(2):203-12
pubmed: 11724031
J Lab Clin Med. 1963 Sep;62:416-30
pubmed: 14061973
J Thromb Haemost. 2004 Dec;2(12):2178-84
pubmed: 15613024
J Thromb Haemost. 2006 Feb;4(2):295-306
pubmed: 16420554
J Thromb Haemost. 2007 May;5(5):925-30
pubmed: 17461926
J Thromb Haemost. 2008 Feb;6(2):399-401
pubmed: 18067604
Natl Med J India. 2008 May-Jun;21(3):116-9
pubmed: 19004141
Semin Perinatol. 2009 Jun;33(3):130-7
pubmed: 19464502
J Thromb Haemost. 2009 Oct;7(10):1737-40
pubmed: 19624461
Lupus. 2010 Apr;19(4):446-52
pubmed: 20353986
Blood Rev. 2011 Mar;25(2):97-106
pubmed: 21242018
J Thromb Haemost. 2011 Sep;9(9):1776-83
pubmed: 21707912
Int J Lab Hematol. 2012 Apr;34(2):208-13
pubmed: 22032515
Br J Haematol. 2012 Apr;157(1):47-58
pubmed: 22313321
Ginekol Pol. 2011 Oct;82(10):749-54
pubmed: 22379938
Lupus. 2012 Oct;21(11):1183-9
pubmed: 22685017
Acta Obstet Gynecol Scand. 2013 Mar;92(3):325-33
pubmed: 23157574
Blood. 2013 Jul 18;122(3):341-7; quiz 466
pubmed: 23649468
Blood. 2014 Jan 16;123(3):404-13
pubmed: 24200687
Autoimmun Rev. 2015 May;14(5):387-95
pubmed: 25555817
Am J Obstet Gynecol. 1985 Oct 1;153(3):322-7
pubmed: 3931480
N Engl J Med. 1985 Nov 21;313(21):1322-6
pubmed: 3932854
Br J Haematol. 1978 Sep;40(1):143-51
pubmed: 568479
Ann Intern Med. 1980 Feb;92(2 Pt 1):156-9
pubmed: 7352719
Blood. 1995 Jul 15;86(2):617-23
pubmed: 7605991
Br J Haematol. 1994 May;87(1):94-9
pubmed: 7947261