ISSN 2997-1036
International Journal of Hematology | Vol. 14, No. 11, November 2023 | pp. 81–88
DOI: 10.46882/2023/IJH/000165
Original Article
Title: Screening for lupus anticoagulant using a simplified textrin time and Russell's viper venom time index protocol in unprovoked deep vein thrombosis
Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³
Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria
Abstract: Diagnosing antiphospholipid syndrome requires robust multi-loop verification steps to successfully isolate circulating inhibitors from baseline clotting factor variations. This prospective diagnostic study evaluated the performance of a combined screening protocol using the textrin time (TT) and the reference dilute Russell’s viper venom time (dRVVT) index loop to detect lupus anticoagulant in 72 adult patients presenting with unprovoked lower limb deep vein thrombosis. Patient plasma matrices underwent sequential 1:1 mixing loops with normal pooled plasma, followed by high-phospholipid corrections to calculate confirmatory ratios. Lupus anticoagulant presence was confirmed in 22.2% (16 of 72) of the thromboembolic cohort. The textrin-dRVVT multi-index protocol achieved a diagnostic sensitivity of 93.7% and a specificity of 91.6% when cross-validated against international standard guidelines. Mixing indexes correlated positively with a history of recurrent pulmonary embolism (r = 0.48, P < 0.05). Notably, the snake venom-based textrin matrix resisted low-molecular-weight heparin or therapeutic warfarin interference, providing an accurate, cost-effective thrombophilia risk-profiling asset for specialized regional clinical pathology laboratories.
Keywords: Lupus anticoagulant, textrin time, diluted Russell’s viper venom time, mixing studies, thrombophilia screening
Manuscript Timeline: Received: August 14, 2023; Revised: September 20, 2023; Accepted: October 10, 2023; Published: November 15, 2023