%0 Journal Article %T Combining Taipan snake venom time/Ecarin time screening with the mixing studies of conventional assays increases detection rates of lupus anticoagulants in orally anticoagulated patients %A Gary W Moore %J Thrombosis Journal %D 2007 %I BioMed Central %R 10.1186/1477-9560-5-12 %X Eighty patients known to have LA who were receiving oral anticoagulation were tested with TSVT/ET and 1:1 mixing studies with normal plasma by dilute Russell's viper venom time (DRVVT) and dilute activated partial thromboplastin time (DAPTT) to assess detection rates by single and multiple assays.Thirty three of the 80 samples from known LA positive patients were positive in all three assays and 15 were positive in combinations of DRVVT, DAPTT or TSVT/ET. The remainder were positive in only one assay; 12 by DRVVT, 4 by DAPTT and 16 by TSVT/ET. Although all DRVVT and DAPTT positive mixing studies generated significant correction of the screen ratio by the confirm ratio, not all confirm ratios corrected back into the reference range. This was the case for 87.5% of the DRVVT results, 44.7% of the DAPTT results and 13.3% of the TSVT/ET positive mixing tests.Addition of TSVT/ET screening for LA in orally anticoagulated patients could increase diagnostic efficacy either by detecting antibodies diluted in the mixing tests of conventional assays or those that do not react in DRVVT or DAPTT. Additionally, TSVT/ET can affirm the presence of a LA where conventional assay mixing tests may not have fully counteracted the oral anticoagulant effect but confirmatory test correction suggests the presence of a LA.Lupus anticoagulants (LA) comprise part of the heterogeneous spectrum of acquired autoantibodies termed antiphospholipid antibodies (APA) [1]. The occurrence and persistence of APA is associated with a wide range of clinical signs and symptoms, most commonly arterial and venous thrombosis, recurrent foetal loss and thrombocytopenia [2].LA are identified in the laboratory by their interference with one or more phospholipid dependent coagulation assays [3]. Although both national [4] and international guidelines [5] have been published in recent years for the laboratory detection of LA, their identification remains a problem, in part due to the limitations in sensitivity and s %U http://www.thrombosisjournal.com/content/5/1/12