Rivaroxaban Therapy, False-Positive Lupus Anticoagulant Screening Results, and Confirmatory Assay Results

被引:6
作者
Murer, Lauren M. [1 ]
Pirruccello, Samuel J. [1 ]
Koepsell, Scott A. [1 ]
机构
[1] Univ Nebraska Med Ctr, Dept Pathol & Microbiol, Omaha, NE 68198 USA
关键词
rivaroxaban; lupus anticoagulant; antiphospholipid syndrome; DIRECT THROMBIN INHIBITORS; DEFINITE ANTIPHOSPHOLIPID SYNDROME; INTERNATIONAL CONSENSUS STATEMENT; CLASSIFICATION CRITERIA; UPDATE; TIME;
D O I
10.1093/labmed/lmw029
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Objective: To examine the effects of patients taking the direct blood coagulation factor Xa inhibitor rivaroxaban on lupus anticoagulant testing results in a clinical setting. Methods: We reviewed the results of lupus anticoagulant testing performed over a 2-year period. Of 59 patients who met criteria for a lupus anticoagulant, 18 were taking rivaroxaban. We reviewed and compared the parameters of lupus anticoagulant testing. Results: The average dilute Russell viper venom time (DRVVT) and normal plasma-mix screening results to confirmation ratios in rivaroxaban-naive patients were 1.6 and 1.7, respectively. In the rivaroxaban group, the same parameters were 1.7 and 1.6, respectively (P = -0.28 and 0.46, respectively). For 15 of 18 patients taking rivaroxaban, results were corrected on the confirmation steps of both tests. Conclusions: Rivaroxaban confounds lupus anticoagulant testing because the DRVVT is prolonged in these patients but it also corrects with excess phospholipid, mimicking a lupus anticoagulant. Patient medication review is critical to avoid false-positive findings and inappropriate diagnosis of antiphospholipid syndrome.
引用
收藏
页码:275 / 278
页数:4
相关论文
共 14 条
[1]  
Clinical and Laboratory Standards Institute (CLSI), 2014, CLSI document H60-A
[2]   Presence of direct thrombin inhibitors can affect the results and interpretation of lupus anticoagulant testing [J].
Genzen, JR ;
Miller, JL .
AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 2005, 124 (04) :586-593
[3]  
Gosselin RC, 2004, ARCH PATHOL LAB MED, V128, P1142
[4]   Effects of the oral, direct factor Xa inhibitor rivaroxaban on platelet-induced thrombin generation and prothrombinase activity [J].
Graff, Jochen ;
von Hentig, Nils ;
Misselwitz, Frank ;
Kubitza, Dagmar ;
Becka, Michael ;
Breddin, Hans-Klaus ;
Harder, Sebastian .
JOURNAL OF CLINICAL PHARMACOLOGY, 2007, 47 (11) :1398-1407
[5]  
Merriman E, 2011, THROMB HAEMOSTASIS, V2011, P105
[6]   International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS) [J].
Miyakis, S ;
Lockshin, MD ;
Atsumi, T ;
Branch, DW ;
Brey, RL ;
Cervera, R ;
Derksen, RHWM ;
De Groot, PG ;
Koike, T ;
Meroni, PL ;
Reber, G ;
Shoenfeld, Y ;
Tincani, A ;
Vlachoyiannopoulos, PG ;
Krilis, SA .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2006, 4 (02) :295-306
[7]   Direct Thrombin Inhibitors and Factor Xa Inhibitors Can Influence the Diluted Prothrombin Time Used as the Initial Screen for Lupus Anticoagulant [J].
Olah, Zsolt ;
Szarvas, Mariann ;
Bereczky, Zsuzsanna ;
Kerenyi, Adrienne ;
Kappelmayer, Janos ;
Boda, Zoltan .
ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE, 2013, 137 (07) :967-973
[8]   Update of the guidelines for lupus anticoagulant detection [J].
Pengo, V. ;
Tripodi, A. ;
Reber, G. ;
Rand, J. H. ;
Ortel, T. L. ;
Galli, M. ;
de Groot, P. G. .
JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2009, 7 (10) :1737-1740
[9]   Antiphospholipid Antibody Syndrome [J].
Sangle, Nikhil A. ;
Smock, Kristi J. .
ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE, 2011, 135 (09) :1092-1096
[10]  
Triplett DA, 2002, ARCH PATHOL LAB MED, V126, P1424