Introduction: Lupus anticoagulant (LA) is an antibody that interferes with in vitro coagulation reactions. The mixing test is considered useful for LA diagnosis and is also recommended to differentiate between acquired hemophilia A (AHA) and factor deficiency. However, there has been little study to differentiate between LA and AHA. Our aims are to investigate whether we can differentiate LA and AHA by the mixing test and to establish new formulas for the mixing test to differentiate these samples clearly. Materials and methods: We examined 27 LA-positive, 29 coagulation factor deficient, 24 unfractionated heparin and 48 AHA samples. Index of circulating anticoagulant (ICA) values, calculated from the clotting times without incubation and after 2 h incubation, were defined as ICA immediate (ICAi) and ICA delayed (ICAd) respectively. ICAd/ICAi and ICAd - ICAi were also calculated to compare the sensitivity and specificity. Results: ICAd/ICAi and ICAd - ICAi for AHA samples were significantly higher than those of the other sample groups. The sensitivities to AHA in ICAi, ICAd, ICAd/ICAi and ICAd - ICAi were 66.7%, 81.3%, 93.8% and 91.7% respectively, while the specificities for AHA were 45.0%, 66.3%, 85.0% and 98.8% respectively. ICAd/ICAi and ICAd - ICAi showed high sensitivity and specificity. Conclusions: ICAd/ICAi and ICAd - ICAi were useful for LA and AHA diagnosis, because these could differentiate between LA and AHA samples. These new formulas can contribute to the rapid diagnosis and treatment of LA and AHA. (C) 2016 Elsevier Ltd. All rights reserved.
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Seoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South KoreaSeoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South Korea
Hong, Sung Kuk
Hwang, Sang Mee
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Seoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South KoreaSeoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South Korea
Hwang, Sang Mee
Kim, Ji-Eun
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Seoul Natl Univ, Coll Med, Inst Canc Res, Seoul 110744, South KoreaSeoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South Korea
Kim, Ji-Eun
Kim, Hyun Kyung
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Seoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South Korea
Seoul Natl Univ, Coll Med, Inst Canc Res, Seoul 110744, South KoreaSeoul Natl Univ, Coll Med, Dept Lab Med, Seoul 110744, South Korea
机构:
Res Dept, Hyphen BioMed, Neuville Oise, France
Sysmex Corp, Kobe, Japan
Natl Inst Adv Ind Sci & Technol, Hlth & Med Res Inst, Takamatsu, JapanRes Dept, Hyphen BioMed, Neuville Oise, France
Kumano, Osamu
Moore, Gary W.
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Addenbrookes Hosp, Dept Haematol, Specialist Haemostasis Unit, Cambridge, England
Middlesex Univ, Dept Nat Sci, London, England
St Thomas Hosp, Dept Haemostasis & Thrombosis, Viapath Analyt, London, EnglandRes Dept, Hyphen BioMed, Neuville Oise, France