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coagulation factor activity PK lupus anticoagulant

 Last Update: 2022-08-10
 Source: Internet
 Author: User

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foreword

Foreword Foreword

Coagulation factors are an important part involved in blood coagulati.

Determination of coagulation factor activity can understand the state of coagulation function of the bo.

Increased coagulation factor activity is common in prethrombotic state and thrombotic diseases, and decreased coagulation factor activity is common in hemophilia, congenital factor II, V, VII and X deficiency, vitamin K deficiency, e.

In clinical work, the common reasons for prolonged activated partial thromboplastin time (APTT) measurement include coagulation factor deficiency, the presence of lupus anticoagulant (LA) or coagulation factor inhibitors,e.

A clear diagnosis requires the detection of coagulation factor levels, LA or coagulation factor inhibitors, e.

case after

case by case by case

In April 2022, in the daily work, the results of a coagulation factor activity measurement caught the author's attention, as shown in Figure 1, the patient's endogenous coagulation factor (FVIII, FIX, FXI, FXIII) activity was significantly reduc.

Figure 1 Result of blood coagulation factor activity test

Looking at the coagulation results of the patient as shown in Figure 2, PT, TT, FIB-C and AT-III were all normal, but APTT was significantly prolong.

Figure 2 Results of coagulation function assay

Seeing these two reports, I initially considered that the APTT prolongation caused by the decreased activity of endogenous coagulation facto.

Check the patient's medical records: the patient, female, 58 years old, was admitted to the hospital mainly because of "found left middle abdominal mass for more than 2 month.

Figure 3 Lupus detection 9 test results

Figure 4 Lupus anticoagulant assay results

The patient's blood routine results showed mild anemia and decreased platelet count, as shown in Figure

Figure 5 Blood routine results

case analysis

case study case study

LA is an antiphospholipid antibody, a heterogeneous immunoglobulin that antagonizes negatively charged phospholipids or phospholipid protein complex.

The principle of APTT coagulation test is to mix the plasma to be tested with contact coagulation factor activator, phospholipid and calcium chloride, and record the time of plasma coagulati.

Based on the above knowledge, it is considered that the prolonged APTT and the decreased activity of endogenous coagulation factors in this patient are likely to be the interference of LA in the patie.

The coagulation factor activity measured after the patient's plasma doubling dilution is shown in Table 1:

TableCoagulation factor activity measured after doubling dilution of patients' plasma

The results showed that with the increase of the dilution factor, the activities of endogenous coagulation factors (FVIII, FIX, FXI, FXI) increased and returned to roughly normal levels, and when they increased to a certain level, they no longer increased with the dilution fact.

Summarize

summary summary

The APTT assay is more sensitive to LA, and the activities of FVIII, FIX, FXI, and FVIII detected by APTT are also susceptible to interferen.

It is necessary for the clinical laboratory to carry out the detection of special items such as coagulation factor activity and LA determination to assist the clinical diagnosis of complex bleeding diseases and thrombotic diseas.

Reviews

Comments Comments

Reviewer: Zhou Yongnian

Lupus anticoagulant is named after it was found in patients with S.

【references】

[1] Shao Shujun, Qi Xin, Dong Xiaofeng, e.

Study on the correlation between hypocoagulable state and coagulation factor activity in tumor patients [.

China Journal of Health Inspection, 2021, 31(23): 2874-287

[2] Zhang Jiahong, Wang Jinxing, Xia Nan, e.

Sensitivity and correlation of activated partial thromboplastin time for detecting lupus anticoagulants [.

Journal of China Medical University, 2021, 50(06): 502-50

[3] Yan Nan, Han Feng, Diao Yanjun, e.

Evaluation of the interference of lupus anticoagulants on the detection of blood coagulation factor activity by dilution method [.

Laboratory Medicine and Clinic, 2021, 18(24): 3588-3590+359

[4] Ma Rui, Ren Jing, Zhang Zhubo, e.

A cross-sectional study of clinical data of patients with lupus anticoagulant positive [.

Journal of Clinical Investigation, 2020, 38(07): 503-50

[5] Zhu Chao, Guan Jialiang, Li Zhe, et .

Correlation study of diluted viper venom time test and mixed test in the detection of lupus anticoagulants [.

Diagnostic Theory and Practice, 2020, 19(01): 28-3

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