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  • Title: The effect of lupus anticoagulant in the second-generation assay for activated protein C resistance.
    Author: Ragland BD, Reed CE, Eiland BM, Tichenor PH, Hudson CL, Fritsma GA, Adler BK, Marques MB.
    Journal: Am J Clin Pathol; 2003 Jan; 119(1):66-71. PubMed ID: 12520699.
    Abstract:
    The activated protein C resistance (APCR) assay is the test of choice to screen for factor V Leiden. We evaluated the effect of lupus anticoagulant on the baseline clotting time of the second-generation APCR assay with plasma samples from 54 patients to determine whether a falsely low APCR ratio could be predicted. We also assessed whether a modification of the assay could make it more reliable in the presence of strong lupus anticoagulants. Of 54 plasma samples, 5 yielded a false-positive APCR ratio, and all 5 had a prolonged baseline clotting time. Further dilution (1:40) of the plasma samples in factor V-deficient plasma led to correction of the APCR ratio and did not affect the sensitivity of the test for factor V Leiden. Our data support that the baseline clotting time is a good predictor of a false-positive APCR test result and should be checked before calculating the ratio. The modified APCR assay reliably identified the false-positive ratios and could be used to screen for factor V Leiden in samples with strong lupus anticoagulant.
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