Laboratory diagnosis of lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ) deficiency:report of 13 cases / 中华检验医学杂志

ABSTRACT

Objective To explore laboratory diagnosis tests for lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.Methods We investigated the coagulation factors'activity,coagulation factors'antibodies,anticardiolipin antibodies,lupus anticoagulant and thrombin generation in thirteen patients of lupus anticoagulant associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency,ten hemophilia A patients, forty-eight healthy people. In these thirteen patients,there were five patients with schizophrenia and had been taking chlorderazin for a long time,two patients with antiphospholipid syndrome, one patient with pemphigus, five patients in which causes of disease were unknown.Among these patients,two patients has haemorrhage,eleven patients don't have reduced.The antibodies of these coagulation factors and LA were positive.Six patients in this group were ACA poslhve,and seven patients were ACA negative.The lag time of eleven non-haemorrage patients with LA positive associated by F Ⅷ,F Ⅸ and F Ⅺ deficiency was(5.60±1.18)min,higher than that of control group which was(1.88±0.25)min.This differenee had statistically significant(t=10.05,P＜0.01).The time to peak was(8.11±1.91)min,significantly higher than that of control group which was (4.10±0.36)min(t=8.83,P＜0.01).The endogenous thrombin potential(ETP)was(1 640.87±higher than that of hemophilia A patients which was(38.50±6.20)%(t=9.77,P＜0.01).The time to peak of hemophilia A patients was(8.01±1.81)min,significantly higher than that of control group which Was(4.10±0.36)min(t=8.20,P＜0.01).The lag time of control group and hemophilia A patients was (1.88±0.25)min and(2.01±0.84)min,respectively.There was no significant difierence of the lag time between these two groups(t=1.26,P＞0.05).Conclusions Diseases like lupus anticoagulant associated bv coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency and inherited hemophilia should use APTT,PT,should be used as confirmation tests. LA and ACA may serve as indication test for identifying the causes of these diseases. ETP and ETP percentage are quite good parametem for predicting the bleeding risk of patients with LA positive associated by coagulation factors(F Ⅷ,F Ⅸ and F Ⅺ)deficiency.