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Target Concepts:
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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The
lupus
anticoagulant (LA) phenomenon created world-wide interest recently. Various tests have been devised to identify LA in plasma, but none of these methods have been universally accepted. In this study 16 cases labelled LA positive by a prior kaolin clotting time (KCT) test were reassessed by four other methods, namely delta KCT (delta kaolin clotting time), APTT (activated partial thromboplastin time),
PNP
(platelet neutralization procedure), and DRVVT (dilute Russell viper venom time). Anti-cardiolipin antibodies (ACL) were also looked for. In our hands the delta KCT proved to be a simple, sensitive test, not influenced by oral anticoagulant therapy, and we recommend it as a screening test. Where the presence of LA is strongly suspected on clinical and other groups, more than one method may be necessary for the diagnosis.
...
PMID:Comparison of four laboratory tests for lupus anticoagulant. 212
An enzyme-linked immunosorbent assay is described for the assay of anti-DNA antibodies. The method employs plastic surface for immobilization of the antigen and alkaline phosphatase-linked rabbit anti-human IgG for the detection of immune complex using
PNP
-P and 4MU-P as substrates. The sensitivity of the assay increased by as much as 16-fold when fluorogenic substrate was used instead of conventional
PNP
-P and could therefore be employed for the detection of low avidity antibodies. Using
PNP
-P as substrate 57% of
SLE
patients were positive for DNA antibody, but if 4MU-P was introduced as substrate, 71% gave a positive response. Moreover, using a fluorogenic substrate, it was possible to minimise the amount of antigen (2 nM bp). The technique is simple, reproducible and of high sensitivity.
...
PMID:Enzyme-linked immunosorbent assay for anti-DNA antibodies using fluorogenic and colorigenic substrates. 660 Nov 54
In 1994, the, French National Quality Control Group for Hematology, Etalonorme, conducted a large-scale interlaboratory survey concerning the detection of
lupus
anticoagulants (LA) involving all the 4,500 French laboratories. Each laboratory received the same batch of a lyophilized citrated plasma (94B3) prepared from a patient with LA that had been confirmed by all the techniques used in the intralaboratory study. In the interlaboratory survey, the screening test was activated partial thromboplastin time (APTT); mean APTT calculated from the results reported by 4,029 labs was prolonged (clotting ratio = 1.44) with a large dispersion (coefficients of variation = 18.8%). APTT of the mixture 94B3 + normal plasma were performed by 2,698 laboratories. No correction of APTT was obtained (R = 1.36, Rosner index = 24) with a wide variation between reagents (17 < Rosner index < 39). Only 15% of the participants performed confirmatory tests; dilute tissue thromboplastin inhibition test (TTI) performed by 509 laboratories gave 75% positive results. Tests with an increased amount of phospholipids (Staclot LA and Staclot
PNP
from Diagnostica Stago), used by 116 and 72 laboratories, gave 88% and 61% positive results, respectively. A total of 1,862 laboratories made the diagnosis of LA. The majority of those who failed in diagnosing LA used an APTT reagent largely used in France, containing kaolin. This survey allowed Etalonorme to inform French biologists and draft an educational program for the biologic detection of LA and the identification of its mechanism of action.
...
PMID:Lupus anticoagulants: first French interlaboratory Etalonorme survey. 865 56
We report a severe hemorrhagic disorder in two pediatric patients with
lupus
anticoagulant (LA) associated to acquired factor II (prothrombin) deficiency. In both patients, hemorrhagic symptoms resolved after corticosteroid therapy. Serial coagulation studies showed that Staclot LA assay was more sensitive than DVVconfirm and Staclot
PNP
tests to confirm the presence of LA when associated with severe factor II deficiency. Both patients had non-neutralizing anti-prothrombin antibodies and their titers inversely correlated with factor II activity (r = -1.0, P < 0.0001). Associated findings in these patients included positive immunologic tests for
systemic lupus erythematosus
, a positive anti-cardiolipin antibody, and anti-beta(2) GPI antibodies in one case. Our findings point out the difficulty in diagnosing LA associated with acquired factor II deficiency and suggest that, in confirmation of its phospholipid dependency, the inclusion of a source of normal human plasma in the test sequence to correct for any factor deficiency and a confirmatory step utilizing hexagonal (II) phase phospholipids may be crucial to the diagnosis of LA in some patients with LA-hypoprothrombinemia syndrome.
...
PMID:Diagnosis of lupus anticoagulant in the lupus anticoagulant-hypoprothrombinemia syndrome: report of two cases and review of the literature. 1241 May 76