Correction of Clotting Factor “Deficiencies” in Plasma from Patients with Lupus-Like Anticoagulants

Lionel P Clyne; Christine L Honig; Nicholas Dainiak

doi:10.1055/s-0038-1661091

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1984; 51(03): 317-320
DOI: 10.1055/s-0038-1661091

Original Article

Schattauer GmbH Stuttgart

Correction of Clotting Factor “Deficiencies” in Plasma from Patients with Lupus-Like Anticoagulants

Lionel P Clyne

The Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, the Department of Pathology, VA Medical Center, West Haven, CT, and the Departments of Biomedical Research and Medicine, St. Elizabeth’s Hospital of Boston and Tufts University, School of Medicine, Boston, MA, U.S.A.

,

Christine L Honig

The Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, the Department of Pathology, VA Medical Center, West Haven, CT, and the Departments of Biomedical Research and Medicine, St. Elizabeth’s Hospital of Boston and Tufts University, School of Medicine, Boston, MA, U.S.A.

,

Nicholas Dainiak

The Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, the Department of Pathology, VA Medical Center, West Haven, CT, and the Departments of Biomedical Research and Medicine, St. Elizabeth’s Hospital of Boston and Tufts University, School of Medicine, Boston, MA, U.S.A.

› Author Affiliations

Abstract

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Summary

Identification of spurious coagulation factor deficiencies that are known to occur in association with lupus-like anticoagulants (LLACs) requires the use of cumbersome laboratory procedures. To determine whether single-stage assays employing the APTT system may be used to identify such artifacts, we measured multiple clotting factor levels by several techniques in plasma of six patients with typical LLACs. While normal activities of factors VIII, IX, XI and XII were measured in only 4/24 APTT assays (17%) employing human plasma substrate, normal factor activities were present in all 24 APTT assays employing bovine, canine or rabbit plasma substrate. Normal factor II, V and X activities were recorded in all but one case in assays that utilized a modified Stypven time, while normal factor VIII levels were determined in 5/6 plasmas when the thromboplastin generation test was employed. These results indicate that the use of heterologous plasma substrates in the APTT system may provide a simple method to identify such coagulation factor “deficiencies”.

Keywords

Heterologous substrates - Lupus inhibitors - Coagulation factor assays

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References

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