PMID- 31989098
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240328
IS  - 2475-0379 (Electronic)
IS  - 2475-0379 (Linking)
VI  - 4
IP  - 1
DP  - 2020 Jan
TI  - The effect of unfractionated heparin, enoxaparin, and danaparoid on lupus 
      anticoagulant testing: Can activated carbon eliminate false-positive results?
PG  - 161-168
LID - 10.1002/rth2.12264 [doi]
AB  - BACKGROUND: Heparins and heparinoids interfere with functional clotting assays 
      used for lupus anticoagulant (LAC) detection. However, current guidelines for LAC 
      testing do not provide clear guidance on this matter. OBJECTIVES: We aimed to 
      assess to effect of unfractionated heparin (UFH), enoxaparin, and danaparoid on 
      LAC assays over broad anti-Xa activity ranges and to evaluate whether activated 
      carbon (AC) is able to neutralize these effects. METHODS: UFH (0.1-3.0 IU/mL), 
      enoxaparin (0.2-2.9 IU/mL), and danaparoid (0.6-2.2 IU/mL) were spiked to normal 
      pooled plasma. AC was added at multiple activity levels. Anti-Xa assays and LAC 
      tests were performed on all samples using Stago analyzers and reagents. RESULTS: 
      Abnormal activated partial thromboplastin time (APTT) screening and mixing tests 
      were obtained at the lowest levels for all compounds. Abnormal APTT confirmation 
      tests were seen from 2.5 and 1.9 anti-Xa IU/mL for enoxaparin and danaparoid, 
      respectively. Abnormal dilute Russell's viper venom test (dRVVT) screening tests 
      were obtained from 1.6, 1.4, and 1.1 anti-Xa IU/mL for UFH, enoxaparin, and 
      danaparoid, respectively. Mixing tests were abnormal from 2.5 and 1.3 anti-Xa 
      IU/mL for enoxaparin and danaparoid, respectively. Abnormal dRVVT confirmation 
      results were seen for danaparoid only from 1.9 anti-Xa IU/mL. AC was unable to 
      neutralize anti-Xa activity in plasma and overcome the effect of the tested 
      anticoagulants on LAC assays but may cause prolongation of APTT clotting times. 
      CONCLUSIONS: UFH, enoxaparin, and danaparoid clearly affected LA tests; however, 
      false-positive LAC conclusions were obtained at supratherapeutic enoxaparin and 
      danaparoid levels only. AC may prolong APTT screen clotting times, requiring 
      3-step testing to avoid potential misdiagnosis of LAC.
CI  - (c) 2019 The Authors. Research and Practice in Thrombosis and Haemostasis published 
      by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and 
      Haemostasis.
FAU - De Kesel, Pieter M M
AU  - De Kesel PMM
AUID- ORCID: 0000-0002-6975-6194
AD  - Coagulation Laboratory Department of Laboratory Medicine Ghent University 
      Hospital Ghent Belgium.
FAU - Devreese, Katrien M J
AU  - Devreese KMJ
AUID- ORCID: 0000-0002-7559-2579
AD  - Coagulation Laboratory Department of Laboratory Medicine Ghent University 
      Hospital Ghent Belgium.
LA  - eng
PT  - Journal Article
DEP - 20191210
PL  - United States
TA  - Res Pract Thromb Haemost
JT  - Research and practice in thrombosis and haemostasis
JID - 101703775
PMC - PMC6971310
OTO - NOTNLM
OT  - carbon
OT  - danaparoid
OT  - enoxaparin
OT  - heparin
OT  - lupus coagulation inhibitor
EDAT- 2020/01/29 06:00
MHDA- 2020/01/29 06:01
PMCR- 2019/12/10
CRDT- 2020/01/29 06:00
PHST- 2019/07/21 00:00 [received]
PHST- 2019/09/12 00:00 [revised]
PHST- 2019/09/14 00:00 [accepted]
PHST- 2020/01/29 06:00 [entrez]
PHST- 2020/01/29 06:00 [pubmed]
PHST- 2020/01/29 06:01 [medline]
PHST- 2019/12/10 00:00 [pmc-release]
AID - S2475-0379(22)01944-6 [pii]
AID - RTH212264 [pii]
AID - 10.1002/rth2.12264 [doi]
PST - epublish
SO  - Res Pract Thromb Haemost. 2019 Dec 10;4(1):161-168. doi: 10.1002/rth2.12264. 
      eCollection 2020 Jan.