ISSN 2997-1036
International Journal of Hematology | Vol. 10, No. 7, July 2019 | pp. 49–56
DOI: 10.46882/2019/IJH/000115
Original Article
Title: Screening for lupus anticoagulant utilizing an integrated dRVVT and dilute Russell's venom confirmation index loop 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: Phospholipid-dependent autoantibodies require precise multiloop screening parameters to avoid false-positive diagnoses caused by circulating coagulation factor variations. This prospective diagnostic study evaluated the performance of an integrated dilute Russell’s viper venom time (dRVVT) screening, mixing, and high-phospholipid confirmation index protocol in 76 adult patients presenting with unprovoked lower limb deep vein thrombosis. Patient matrices underwent sequential 1:1 mixing steps paired with high-density bilayer phospholipid corrections to yield normalized target ratios. Lupus anticoagulant presence was confirmed in 21.0% (16 of 76) of the thromboembolic cohort. The integrated triple-loop confirmation protocol achieved a diagnostic sensitivity of 93.7% and a specificity of 91.6% when validated against international reference reference standard guidelines. Calculated confirmation ratios correlated positively with a clinical history of recurrent pulmonary embolism (r = 0.48, P < 0.05). Utilizing this multi-step electronic index loop minimizes the impact of baseline clotting factor deficiencies, providing a highly reliable and reproducible thrombophilia risk-profiling asset for specialized clinical pathology laboratories.
Keywords: Lupus anticoagulant, diluted Russell’s viper venom time, mixing studies, venous thromboembolism, thrombophilia screening
Manuscript Timeline: Received: April 14, 2019; Revised: May 20, 2019; Accepted: June 08, 2019; Published: July 16, 2019