Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun;46(3):538-545.
doi: 10.1111/ijlh.14240. Epub 2024 Feb 1.

Taipan snake venom time has high sensitivity for lupus anticoagulants in non-anticoagulated, triple positive antiphospholipid syndrome patients

Gary W Moore  1   2 , Sean Platton  3 , Nada Yartey  4 , Eleanor Foxton  5 , Danielle White  1 , Stephen G MacDonald  1
Affiliations

Taipan snake venom time has high sensitivity for lupus anticoagulants in non-anticoagulated, triple positive antiphospholipid syndrome patients

Gary W Moore et al. Int J Lab Hematol. 2024 Jun.

Abstract

Introduction: Dilute Russell's viper venom time (dRVVT) and activated partial thromboplastin time (APTT) are the mainstay assays in lupus anticoagulant (LA) detection yet they have limitations, particularly in relation to interferences and specificity. The recently validated Taipan snake venom time (TSVT) screening with ecarin time (ET) confirmatory assays overcome many of those limitations due to the innate specificity engendered from direct prothrombin activation, and insensitivity to the effects of vitamin K antagonists (VKA). The present study aimed to further evidence diagnostic utility of TSVT/ET by performing them in samples from 116 nonanticoagulated patients with established triple-positive antiphospholipid syndrome (APS).

Methods: Samples were identified in three expert centres who performed dRVVT, APTT and solid phase antiphospholipid antibody assays with reagents from a variety of manufacturers. All samples additionally received TSVT/ET analysis using standardised reagents.

Results: Ninety seven of 116 (83.6%) were dRVVT- and APTT-positive, 85/97 (87.6%) of which were TSVT/ET-positive, 9/116 (7.8%) were dRVVT-positive only, 6 of which were TSVT/ET-positive, and 10/116 (8.6%) were APTT-positive only, 5 of which were TSVT/ET-positive. 96/116 TSVT/ET-positivity returned a high sensitivity for LA of 82.8%. Low coefficients of determination revealed weak relationships between LA potency and anticardiolipin and anti-β2-glycoprotein I antibody titres for all three LA assays.

Conclusions: TSVT/ET has high sensitivity for the clinically significant LA found in triple positive APS patients. TSVT/ET can establish multiple LA assay positivity in nonanticoagulated patients negative for one of dRVVT or APTT, and is the only assay pairing insensitive to VKAs, the recommended anticoagulation for APS.

Keywords: antiphospholipid antibodies; antiphospholipid syndrome; ecarin time; lupus anticoagulant; taipan snake venom time.

PubMed Disclaimer

References

REFERENCES

    1. Chaturvedi S, McCrae KR. Diagnosis and management of the antiphospholipid syndrome. Blood Rev. 2017;31:406‐417.
    1. Moore GW. Testing for lupus anticoagulants. Semin Thromb Hemost. 2022;48:643‐660.
    1. Pengo V, Ruffatti A, Legnani C, et al. Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome. J Thromb Haemost. 2010;8:237‐242.
    1. Latino JO, Udry S, Aranda FM, Perés Wingeyer SDA, Fernández Romero DS, de Larrañaga GF. Pregnancy failure in patients with obstetric antiphospholipid syndrome with conventional treatment: the influence of a triple positive antibody profile. Lupus. 2017;26:983‐988.
    1. Pengo V, Ruffatti A, Legnani C, et al. Incidence of a first thromboembolic event in asymptomatic carriers of high‐risk antiphospholipid antibody profile: a multicenter prospective study. Blood. 2011;118:4714‐4718.

Substances

LinkOut - more resources