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

J Goudemand; C Caron; D De Prost; A Derlon; J Y Borg; J Sampol; P Sié; 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

doi:10.1055/s-0038-1655965

Thrombosis and Haemostasis, Table of Contents

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

¹Laboratoire d’Hématologie, Hôpital Huriez, Lille

,

C Caron

¹Laboratoire d’Hématologie, Hôpital Huriez, Lille

,

D De Prost

²Service d’Hématologie, Hôpital Bichat, Paris

,

A Derlon

³Laboratoire d’Hématologie, CHRU Côte de Nacre, Caen

,

J Y Borg

⁴Laboratoire d’Hématologie, Hôpital Charles Nicolle, Rouen

,

J Sampol

⁵Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille

,

P Sié

⁶Laboratoire 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

› Author Affiliations

Abstract

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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).

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References

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