ISSN 2997-1036
International Journal of Hematology | Vol. 11, No. 5, May 2020 | pp. 33–40
DOI: 10.46882/2020/IJH/000125
Original Article
Title: Screening for lupus anticoagulant using a simplified textrin time and activated partial thromboplastin time mixing protocol in unprovoked deep vein thrombosis
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: Guidelines for diagnosing antiphospholipid syndrome require specific testing parameters that minimize false-positive results caused by circulating clotting factor variations. This prospective diagnostic study evaluated the performance of a combined screening protocol using the textrin time (TT) and the activated partial thromboplastin time (aPTT) mix to detect lupus anticoagulant in 70 adult patients presenting with acute, unprovoked lower limb deep vein thrombosis. Patient plasma underwent sequential 1:1 and 4:1 mixing loops with normal pooled plasma, followed by high-phospholipid corrections to calculate confirmatory ratios. Lupus anticoagulant presence was confirmed in 22.8% (16 of 70) of the thromboembolic cohort. The textrin-aPTT dual mixing protocol achieved a diagnostic sensitivity of 93.7% and a specificity of 91.3% when cross-validated against international guidelines. Mixing indexes correlated positively with a clinical history of recurrent thrombotic events (r = 0.48, P < 0.05). Notably, the textrin-based step resisted interference from low-molecular-weight heparin due to its direct prothrombin activation pathway, providing a cost-effective and accurate thrombophilia risk-profiling asset for specialized clinical pathology laboratories.
Keywords: Lupus anticoagulant, textrin time, activated partial thromboplastin time, mixing studies, deep vein thrombosis
Manuscript Timeline: Received: February 12, 2020; Revised: March 20, 2020; Accepted: April 05, 2020; Published: May 15, 2020
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