Importance of the dilution test in the dosageof coagulation factors XII and XI in plasma withpositive lupus anticoagulant

Martha  Castillo; Ana Isabel Mora Bautista; Ana lucía Oliveros; Gloria Ramos; Maria Elena  Muñoz Zambrano; Jonathan Andre  Mora

doi:10.22490/24629448.7539

Vol. 21 No. 41 (2023): International Issue

Published 2023-12-16

license

Article (before OJS)

Importance of the dilution test in the dosageof coagulation factors XII and XI in plasma withpositive lupus anticoagulant

DOI: https://doi.org/10.22490/24629448.7539

Martha Castillo Universidad Colegio Mayor de Cundinamarca

Ana Isabel Mora Bautista Universidad Colegio Mayor de Cundinamarca

Ana lucía Oliveros Universidad Colegio Mayor de Cundinamarca

Gloria Ramos Universidad Militar Nueva Granada

Maria Elena Muñoz Zambrano Universidad Nacional Mayor de San Marcos

Jonathan Andre Mora Fundación Santa Fe de Bogotá

PDF (Spanish)

Abstract
References

Introduction. Thrombosis is associated with acquired risk factors or hypercoagulable
states. Antiphospholipid antibodies are found in infectious processes or associated with

arterial or venous thrombosis. Among these is the lupus anticoagulant, which is conside-
red an interference inhibitor because it prolongs phospholipid-dependent tests in vitro.

Objectives. To relate the activity of factor XII and XI in patients with positive lupus anti-
coagulant. Methodology. Of 55 plasmas, 34 met the inclusion criteria. Factors XII and XI

were dosed by metric clot methods. Samples less than 50 Ul/dl are considered low factor
activity, to which the dilution test (parallelism) is performed. If a recovery greater than
15% of the factor is evidenced, it is considered interference. If, on the contrary, the result
remains with little variation, it is confirmed. factor deficiency. Results. Of 34 dosages,
79.4% (27/34) presented a decrease in factor XI. A dilution test was performed, and 100%
recovery of factor XI was observed; Regarding the dosage of factor XII, 29.4% (10/34)
presented values below 50 IU/dl and 70.6% (24/34) normal, did not recover in 22.2%
(2/9) presenting deficit. Conclusions. The study of a prolonged PTT is carried out due to
suspicion of lupus anticoagulant or factor deficiency. The importance of the laboratory is
that every time a decreased coagulation factor is found, plasma dilution must be done to
determine if there is recovery of the factor or is a deficit of this.

keywords: Antiphospholipid Syndrome, Dilution, Factor XII, Factor X, Anticoagulant, Lupus

Núñez-Álvarez CA, Cabiedes J. Pathogenic mechanisms of antiphospholipid antibodies. Rheumatol Clin [Internet]. 2011 ;7(1 ): 72–6. Available at: https://www.reumatologia- clinica.org/es-mecanismos-pathogenicos-anticuerpos-anti- fosfolipidos-articulo-S1699258X09002459

Garcia D, Erkan D. Diagnosis, and management of the an- tiphospholipid syndrome. N Engl J Med [Internet]. 2018 ;378(21) :2010–21. Available at: http://dx.doi.org/10.1056/ NEJMra1705454

Chaturvedi S, McCrae KR. Diagnosis, and management of the antiphospholipid syndrome. Blood Rev [Internet]. 2017; 31(6) :406–17. Available at: https://pubmed.ncbi.nlm.nih. gov/28784423/

Petri M. Improvements in diagnosis and risk assessment of primary and secondary antiphospholipid syndrome. Hema- tol Am Soc Hematol educate Progr . 2019; 2019(1): 415- 420.

Espinosa G, Cervera R, Font J, Reverter JC, Shoenfeld Y. Thrombotic mechanisms in antiphospholipid syndrome. Immunology [Internet]. 2003;22(1):53–62. Available at: https://ibecs.isciii.es/cgi-bin/wxislind.exe/iah/online/?IsisS- cript=iah/iah.xis&src=google&base=IBECS&lang=e&nex- tAction=lnk&exprSearch=37241&indexSearch=ID

Giannakopoulos B, Krilis SA. The pathogenesis of the an- tiphospholipid syndrome. N Engl J Med [Internet]. 2013 ;368(11) :1033–44. Available at: https://pubmed.ncbi.nlm. nih.gov/23484830/

Wang X, Cheng Q, Xu L, Feuerstein GZ, Hsu MY, Smith PL, et al. Effects of factor IX or factor XI deficiency on ferric chloride-induced carotid artery occlusion in mice: Thrombo- sis in FIX- and FXI-deficient mice. J Thromb Haemost [Internet]. 2005 ;3(4) :695–702. Available at: https://pubmed. ncbi.nlm.nih.gov/15733058/

Renné T, Pozgajová M, Grüner S, Schuh K, Pauer HU, Burfeind P, et al. Defective thrombus formation in mice lacking coagulation factor XII. J Exp Med [Internet]. 2005;202(2):271–81. Available at: https://pubmed.ncbi. nlm.nih.gov/16009717/

Del Carpio- Orantesa L. Deficiency of coagulation factors IX, XI, XII and systemic lupus erythematosus. Rev Hematol Mex. 2019;20(2):137-141.

Chaudhry LA, El- Sadek WYM, Chaudhry GA, Al- Atawi FE. Factor XII (Hageman Factor) Deficiency: a rare harbin- ger of life-threatening complications. Pan Afr Med J [Inter- net]. 2019; 33:39. Available at : https://pubmed.ncbi.nlm. nih.gov/31384354/

Giannakopoulos B, Gao L, Qi M, Wong JW, Yu DM, Vla- choyiannopoulos PG, et al. Factor XI is a substrate for oxido- reductases: enhanced activation of reduced FXI and its role in antiphospholipid syndrome thrombosis. J Autoimmune [Internet]. 2012 ;39(3) :121–9. Available at: https://pub- med.ncbi.nlm.nih.gov/22704541/

Emsley J, McEwan PA, Gailani D. Structure, and function of factor XI. Blood [Internet]. 2010 ;115(13 ): 2569–77. Avai- lable at: https://pubmed.ncbi.nlm.nih.gov/20110423/

Amory CF, Levine SR, Brey RL, Gebregziabher M, Tuhrim S, Tilley BC, et al. Antiphospholipid antibodies and recu- rrent thrombotic events: Persistence and portfolio. Cerebro- vasc Dis [Internet]. 2015 ;40(5–6):293–300. Available at : https://pubmed.ncbi.nlm.nih.gov/26513489/

Hell L, Ay C, Posch F, Gebhart J, Koder S, mackman N,Pa- binger I, Thaler J. low stracellillary vesicle-associated Tissue factor activity in patients with persistent lupus anticoagulant and a history of thrombosis. Ann Hematol . 2019 Feb;98(2): 313-319.

Mackworth-Young CG. Antiphospholipid syndrome: multi- ple mechanisms. Clin Exp Immunol [Internet]. 2004 ;136(3 ): 393–401. Available at: http://dx.doi.org/10.1111/j.1365- 2249.2004.02497.x

Hoxha A, Banzato A, Ruffatti A, Pengo V. Detection of lupus anticoagulant in the era of direct oral anticoagulants. Au- toimmune Rev [Internet]. 2017 ;16(2 ): 173–8. Available at: https://pubmed.ncbi.nlm.nih.gov/27988438/

Merriman E, Kaplan Z, Butler J, Malan E, Gan E, Tran H. Rivaroxaban, and false positive lupus anticoagulant testing. Thromb Haemost [Internet]. 2011;105(2):385–6. Available at : https://pubmed.ncbi.nlm.nih.gov/21103666/

Arachchillage DRJ, Mackie IJ, Efthymiou M, Isenberg DA, Machin SJ, Cohen H. Interactions between rivaroxaban and antiphospholipid antibodies in thrombotic antiphos- pholipid syndrome. J Thromb Haemost [Internet]. 2015; 13(7): 1264–73. Available at: https://pubmed.ncbi.nlm.nih. gov/25850997/

Pengo V, Denas G. Diagnostics, and treatment of thrombotic antiphospholipid syndrome (APS): A personal perspective. Thromb Res [Internet]. 2018 ;169 :35–40. Available at: ht- tps://pubmed.ncbi.nlm.nih.gov/30007134/

Favaloro EJ, Mohammed S, Curnow J, Pasalic L. Laboratory testing for lupus anticoagulant (LA) in patients taking direct oral anticoagulants (DOACs): potential for false positives and false negatives. Pathology. 2019 Apr;51(3):292-300.

Marine L, Urbina J, Bergoeing M, Valdés F, Mertens R, Kramer A. Mechanical and pharmacomechanical Throm- bolysis in deep venous thrombosis with no clinical respon- se to conventional treatment. Rev Med Chil [Internet]. 2017;145(1): 63–71. Available at: https://pubmed.ncbi.nlm. nih.gov/28393971/

Tripodi A, Cohen H, Devreese KMJ. Lupus anticoagulant detection in anticoagulated patients. Guidance from the Scientific and Standardization Committee for lupus anticoa- gulant/antiphospholipid antibodies of the International So- ciety on Thrombosis and Haemostasis . J Thromb Haemost . 2020; 18(7): 1569-1575.

Devreese KMJ, Ortel TL, Pengo V, de Laat B. Subcommi- ttee on Lupus Anticoagulant/Antiphospholipid A. Labora- tory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH. J Thromb Haemost . 2018; 16(4): 809-813.

Cohen H, Mackie IJ, Devreese KMJ. Clinical and laboratory practice for lupus anticoagulant testing: an International So- ciety of Thrombosis and Haemostasis Scientific and Stan- dardization Committee survey. J Thromb Haemost . 2019; 17(10): 1715-1732.

Carmi O, Berla M, Shoenfeld Y, Levy Y. Diagnosis and management of catastrophic antiphospholipid syndro- me. Expert Rev Hematol . 2017 Apr;10(4):365-374. doi : 10.1080/17474086.2017.1300522. Epub 2017 Mar 13. PMID: 28277850.

Tektonidou MG, Andreoli L, Limper M, et al. EULAR re- commendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis. 2019; 78(10): 1296- 1304.

Srivastava A, Santagostino E, Dougall A, Kitchen S, Suther- land M, Pipe SW, et al. WFH Guidelines for the Manage- ment of Hemophilia, 3rd edition. Haemophilia [Internet]. 2020 ;26 Suppl 6(S6) :1–158. Available at: https://pubmed. ncbi.nlm.nih.gov/32744769/

license

How to Cite

Castillo , M. ., Mora Bautista, A. I., Oliveros , A. lucía, Ramos , G., Muñoz Zambrano , M. E. ., & Mora, J. A. . (2023). Importance of the dilution test in the dosageof coagulation factors XII and XI in plasma withpositive lupus anticoagulant. NOVA Biomedical Sciences Journal, 21(41). https://doi.org/10.22490/24629448.7539

Download Citation

Almétricas

Metrics

File downloads

Declaración de privacidad.

Importance of the dilution test in the dosageof coagulation factors XII and XI in plasma withpositive lupus anticoagulant

Declaración de privacidad.