Coagulation assays for the lupus anticoagulant: review and critique of current methodology.

Abstract

Several coagulation assays identify lupus anticoagulants, but there is no uniform opinion regarding minimum criteria for the diagnosis or the most sensitive procedure to be used to screen for lupus anticoagulants. Based on test availability and the cumulative literature, a sensitive activated partial thromboplastin time appears to be the most appropriate screening test. The dilute Russell's viper venom time may be used as both a screening and a confirmatory procedure. The platelet neutralization procedure is the most sensitive and specific of the confirmatory procedures that use an increased amount of phospholipid to either "bypass" or "neutralize" the lupus anticoagulant.