{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:26:02Z","timestamp":1774916762095,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the utility of the dilute prothrombin time (DPT) in diagnosing antiphospholipid syndrome (APS), alone and when paired with the dilute Russell viper venom time (DRVVT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Dilute prothrombin time and DRVVT testing was performed on plasma samples spiked with apixaban or rivaroxaban, or depleted of vitamin K\u2013dependent clotting factors. A retrospective analysis of all functional APS testing results over a 44-month period at the University of Chicago Medical Center was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In spiking studies, the screening clotting time in the DPT (DPTS) is more sensitive to deficiency of vitamin K\u2013dependent factors than is the screening clotting time in the DRVVT (DRVVTS). The converse is true for factor Xa direct oral anticoagulant (DOAC)\u2013spiked plasma. In a 44-month retrospective analysis, only 2.6% of clinical APS panels showed isolated positivity in the DPT-based system. Comparing the DPT-based system with the DRVVT-based system showed utility in identifying false-positive DRVVT results due to anticoagulation. A DRVVTS\/DPTS ratio of 0.785 or lower predicted an international normalized ratio of 1.5 or higher (sensitivity, 86.3%; specificity, 60.4%; likelihood ratio, 2.18). Conversely, a DRVVTS\/DPTS ratio of 1.165 or higher was the optimal cutoff for predicting the identification of factor Xa DOAC (sensitivity, 61.8%; specificity, 77.8%; likelihood ratio, 2.78). Within the data set that had full DRVVT and DPT results, parameters were identified that could further improve identification of samples with anticoagulation interference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Dilute prothrombin time lupus anticoagulant assay is rarely the sole laboratory functional evidence for APS, but when combined with the DRVVT, the DPT can serve as an effective screen for common anticoagulant interference.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqae044","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T06:35:02Z","timestamp":1715668502000},"page":"379-391","source":"Crossref","is-referenced-by-count":1,"title":["The utility of the dilute prothrombin time in the interpretation of antiphospholipid syndrome testing"],"prefix":"10.1093","volume":"162","author":[{"given":"Noah A","family":"Mehr","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Chicago , Chicago, IL ,","place":["US"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6687-9236","authenticated-orcid":false,"given":"Tanner E","family":"Storozuk","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Chicago , Chicago, IL ,","place":["US"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof L","family":"Mikrut","sequence":"additional","affiliation":[{"name":"Clinical Laboratories, University of Chicago Medicine , Chicago, IL ,","place":["US"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey D","family":"Wool","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Chicago , Chicago, IL ,","place":["US"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"2024100319021477000_CIT0001","first-page":"295","article-title":"International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)","volume-title":"J Thromb Haemost.","author":"Miyakis","year":"2006"},{"key":"2024100319021477000_CIT0002","first-page":"70","article-title":"Antiphospholipid syndrome","volume-title":"Transl Res.","author":"Petri","year":"2020"},{"key":"2024100319021477000_CIT0003","first-page":"2010","article-title":"Diagnosis and management of the antiphospholipid syndrome","volume-title":"N Engl J Med.","author":"Garcia","year":"2018"},{"key":"2024100319021477000_CIT0004","first-page":"2828","article-title":"Guidance from the Scientific and Standardization Committee for lupus anticoagulant\/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: update of the guidelines for lupus anticoagulant detection and interpretation","volume-title":"J Thromb Haemost.","author":"Devreese","year":"2020"},{"key":"2024100319021477000_CIT0005","first-page":"1866","article-title":"Unveiling the complex effects of direct oral anticoagulants on dilute Russell\u2019s viper venom time assays","volume-title":"J Thromb Haemost.","author":"Hillarp","year":"2020"},{"key":"2024100319021477000_CIT0006","first-page":"1569","article-title":"Lupus anticoagulant detection in anticoagulated patients: guidance from the Scientific and Standardization Committee for lupus anticoagulant\/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis","volume-title":"J Thromb Haemost.","author":"Tripodi","year":"2020"},{"key":"2024100319021477000_CIT0007","first-page":"643","article-title":"Testing for lupus anticoagulants","volume-title":"Semin Thromb Hemost.","author":"Moore","year":"2022"},{"key":"2024100319021477000_CIT0008","first-page":"1737","article-title":"Update of the guidelines for lupus anticoagulant detection: Subcommittee on Lupus Anticoagulant\/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis","volume-title":"J Thromb Haemost.","author":"Pengo","year":"2009"},{"key":"2024100319021477000_CIT0009","first-page":"47","article-title":"Guidelines on the investigation and management of antiphospholipid syndrome","volume-title":"Br J Haematol.","author":"Keeling","year":"2012"},{"key":"2024100319021477000_CIT0010","volume-title":"Laboratory Testing for the Lupus Anticoagulant; Approved Guideline","author":"Clinical and Laboratory Standards Institute"},{"key":"2024100319021477000_CIT0011","first-page":"1700","article-title":"Effects of direct oral anticoagulants on lupus anticoagulant assays in a real-life setting","volume-title":"Thromb Haemost.","author":"Antovic","year":"2017"},{"key":"2024100319021477000_CIT0012","first-page":"632","article-title":"The effects of indirect- and direct-acting anticoagulants on lupus anticoagulant assays","volume-title":"Am J Clin Pathol.","author":"Seheult","year":"2017"},{"key":"2024100319021477000_CIT0013","first-page":"299","article-title":"How I treat anticoagulant-refractory thrombotic antiphospholipid syndrome","volume-title":"Blood.","author":"Cohen","year":"2021"},{"key":"2024100319021477000_CIT0014","first-page":"715878","article-title":"Use of direct oral anticoagulants in patients with antiphospholipid syndrome: a systematic review and comparison of the international guidelines","volume-title":"Front Cardiovasc Med","author":"Pastori","year":"2021"},{"key":"2024100319021477000_CIT0015","first-page":"235","article-title":"Lupus-anticoagulant testing at NOAC trough levels","volume-title":"Thromb Haemost.","author":"Ratzinger","year":"2016"},{"key":"2024100319021477000_CIT0016","first-page":"144","article-title":"Frequent false-positive results of lupus anticoagulant tests in plasmas of patients receiving the new oral anticoagulants and enoxaparin","volume-title":"Int J Lab Hematol.","author":"Martinuzzo","year":"2014"},{"key":"2024100319021477000_CIT0017","first-page":"1264","article-title":"Interactions between rivaroxaban and antiphospholipid antibodies in thrombotic antiphospholipid syndrome","volume-title":"J Thromb Haemost.","author":"Arachchillage","year":"2015"},{"key":"2024100319021477000_CIT0018","first-page":"94","article-title":"Optimization of the dilute prothrombin time for the detection of the lupus anticoagulant by use of a recombinant tissue thromboplastin","volume-title":"Br J Haematol.","author":"Arnout","year":"1994"},{"key":"2024100319021477000_CIT0019","first-page":"177","article-title":"Dilute prothrombin time-based lupus ratio test: integrated LA testing with recombinant tissue thromboplastin","volume-title":"Thromb Res.","author":"Liest\u00f8l","year":"2002"},{"key":"2024100319021477000_CIT0020","first-page":"404","article-title":"Evaluation of a new commercial dilute prothrombin time in the diagnosis of lupus anticoagulants","volume-title":"Thromb Res.","author":"Devreese","year":"2008"},{"key":"2024100319021477000_CIT0021","first-page":"1043","article-title":"A single test to assay warfarin, dabigatran, rivaroxaban, apixaban, unfractionated heparin, and enoxaparin in plasma","volume-title":"J Thromb Haemost.","author":"Letertre","year":"2016"},{"key":"2024100319021477000_CIT0022","first-page":"2164","article-title":"Laboratory diagnosis of antiphospholipid syndrome: insights and hindrances","volume-title":"J Clin Med","author":"Vandevelde","year":"2022"},{"key":"2024100319021477000_CIT0023","first-page":"315","article-title":"Comparison of six dilute Russell viper venom time lupus anticoagulant screen\/confirm assay kits","volume-title":"Semin Thromb Hemost.","author":"McGlasson","year":"2013"},{"key":"2024100319021477000_CIT0024","first-page":"567","article-title":"Screening test for direct oral anticoagulants with the dilute Russell viper venom time","volume-title":"Eur J Haematol.","author":"Pratt","year":"2018"},{"key":"2024100319021477000_CIT0025","year":"2023"},{"key":"2024100319021477000_CIT0026","first-page":"292","article-title":"Laboratory testing for lupus anticoagulant (LA) in patients taking direct oral anticoagulants (DOACs): potential for false positives and false negatives","volume-title":"Pathology (Phila).","author":"Favaloro","year":"2019"},{"key":"2024100319021477000_CIT0027","year":"2016"},{"key":"2024100319021477000_CIT0028","first-page":"E166","article-title":"High frequency of false-positive results of aPTT-based lupus anticoagulant tests in patients receiving argatroban","volume-title":"Am J Hematol.","author":"Villalba","year":"2019"},{"key":"2024100319021477000_CIT0029","first-page":"e204","article-title":"Impact of a commercially available DOAC absorbent on two integrated procedures for lupus anticoagulant detection in plasma containing argatroban","volume-title":"Int J Lab Hematol.","author":"Scalambrino","year":"2022"}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/162\/4\/379\/59562141\/aqae044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/162\/4\/379\/59562141\/aqae044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T19:02:25Z","timestamp":1727982145000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/162\/4\/379\/7671197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,14]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,5,14]]},"published-print":{"date-parts":[[2024,10,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqae044","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"value":"0002-9173","type":"print"},{"value":"1943-7722","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,5,14]]}}}