Lupus anticoagulant testing: Dilute prothrombin time (dPT)

Book chapter

Moore, G. 2023. Lupus anticoagulant testing: Dilute prothrombin time (dPT). in: Favaloro, E. and Gosselin, R. (ed.) Hemostasis and Thrombosis: Methods and Protocols New York, NY Humana.
Chapter titleLupus anticoagulant testing: Dilute prothrombin time (dPT)
AuthorsMoore, G.

Lupus anticoagulants (LA) rarely affect routine prothrombin time assays because the high phospholipid (PL) content in thromboplastin reagents tends to overwhelm the antibodies. Dilution of thromboplastin to create a dilute prothrombin time (dPT) screening test renders the assay sensitive to the presence of LA. Technical and diagnostic performances are enhanced if recombinant thromboplastins are employed in place of tissue-derived reagents. Presence of an LA cannot be deduced from an elevated screening test alone since other coagulation disturbances can prolong clotting times. Confirmatory testing with less dilute or undiluted thromboplastin reveals the PL-dependent nature of LA by reducing the clotting time relative to that of the screening test. Where appropriate, such as a known or suspected coagulation factor deficiency, mixing tests are valuable in correcting factor deficiencies and evidencing inhibitory properties of LA, to increase diagnostic specificity. Although LA testing is commonly restricted to dilute Russell's viper venom time and activated partial thromboplastin time, dPT is sensitive to LA unreactive in those assays, and inclusion in routine testing increases detection rates of clinically significant antibodies.

KeywordsAntiphospholipid Syndrome - diagnosis, Thrombosis, Antiphospholipid antibodies, Lupus Coagulation Inhibitor, Phospholipids, Blood Coagulation Tests, Humans, Antiphospholipid syndrome, Dilute prothrombin time, Phospholipid, Partial Thromboplastin Time, Prothrombin Time, Thromboplastin, Lupus anticoagulant
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
Book titleHemostasis and Thrombosis: Methods and Protocols
EditorsFavaloro, E. and Gosselin, R.
Place of publicationNew York, NY
SeriesMethods in Molecular Biology (Clifton, N.J.)
Publication dates
Online20 May 2023
Print20 May 2023
Publication process dates
Deposited01 Jun 2023
Output statusPublished
Digital Object Identifier (DOI)
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