ISSN 2997-1036
International Journal of Hematology | Vol. 8, No. 11, November 2017 | pp. 81–88
DOI: 10.46882/2017/IJH/000095
Original Article
Title: Screening for lupus anticoagulant using a simplified textrin time and ecarin clotting time ratio protocol in patients with unprovoked venous thromboembolism
Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³
Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria
Abstract: Diagnosing antiphospholipid syndrome requires specialized testing protocols that minimize false-positive results caused by concurrent therapeutic anticoagulants. This prospective study evaluated the diagnostic accuracy of a combined snake venom clotting protocol using the textrin time (TT) and the ecarin clotting time (ECT) to detect lupus anticoagulant in 62 adult patients presenting with unprovoked deep vein thrombosis. Both test systems utilized baseline screening steps followed by high-phospholipid confirmation loops to generate diagnostic ratios, with results cross-validated against reference diluted Russell’s viper venom time guidelines. Lupus anticoagulant presence was confirmed in 20.9% (13 of 62) of the thrombotic patients. The textrin-ecarin dual ratio protocol achieved a diagnostic sensitivity of 92.3% and a specificity of 91.8%. Notably, the ecarin-based confirmation step resisted interference from therapeutic low-molecular-weight heparin or therapeutic warfarin due to direct prothrombin activation pathways. Utilizing this dual snake venom protocol offers an accurate, cost-effective screening alternative for specialized thrombosis laboratories handling patients on active anticoagulant regimens.
Keywords: Lupus anticoagulant, textrin time, ecarin clotting time, venous thromboembolism, snake venoms
Manuscript Timeline: Received: August 15, 2017; Revised: September 22, 2017; Accepted: October 10, 2017; Published: November 18, 2017