Abdul Mannan Explains How DOACs Can Confuse Lupus Anticoagulant Testing
Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board, has shared a post on LinkedIn:
“Late on a Friday, Dr. Jones reviewed a DRVVT:
• Screen: prolonged
• Mix: no correction
• Confirm: completely normalised
With a confident grin, he declared: ‘Classic Lupus Anticoagulant.’
Diagnosis: Antiphospholipid Syndrome.
Actually, the patient was on rivaroxaban.
The apparent ‘LA’ was nothing more than a DOAC in disguise, and the confirm reagent just happened to mask the culprit.
Moral of the story
Before calling ‘Eureka!’ in the coagulation lab, always check for anticoagulants. DOACs can mimic lupus anticoagulant and mislead even the most confident interpretation.
Learning point
Pre-analytical details are not small print. They are often the hidden plot twists in coagulation testing.”
For more information, check here.
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