1. Is sample collection critical for lupus anticoagulant testing?
Yes. Besides heparin contamination, other pretest variables may have a significant impact on detecting the lupus anticoagulant. The blood sample is collected in a special citrated tube and centrifuged to remove the
plasma for testing. There must be the proper amount of blood in the tube and it cannot be clotted. When the blood is properly centrifuged, most of the platelets are removed from the test sample. If there are too many platelets in the plasma sample, it may be compromised (because platelets are a source of phospholipids). Also, if the patientÂ’s
hematocrit is very high, test results may be affected.
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2. How is a lupus anticoagulant treated?
No treatment is required if someone does not have any symptoms. If blood clots do occur, patients are usually anticoagulated with heparin (which is injected under the skin or given intravenously (IV)) followed by oral warfarin (coumadin) therapy for several months. Higher than usual doses of warfarin may be required, and the treatment may need to be continued for a longer period of time. In someone with the lupus anticoagulant, the risk of recurrence of both arterial and venous thrombotic episodes is relatively high. Some patients may need to be on long-term (even life-long) oral anticoagulation.
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3. Which is more common: anticardiolipin or LA?
In general, anticardiolipin antibodies are more common than the lupus anticoagulant. Anticardiolipin antibodies occur approximately five times more often than the lupus anticoagulant in patients with the antiphospholipid antibody syndrome. About sixty percent of those with the lupus anticoagulant will also have anticardiolipin antibodies.
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