Article Figures & Data
Figures
- Figure 1.
β2GPI and antibody. β2GPI and antibody to β2GPI binding to a phospholipid surface. B2GPI consists of 5 homologous domains. Domain V binds to the anionic phospholipid surface. The anti-β2GPI antibody binds to domain I.
- Figure 2.
Interaction of specific LAC assays within the coagulation cascade. The heterogeneous nature of the LAC requires multiple assays to improve diagnostic sensitivity. (dPT, dilute Prothrombin Time; dRVVT, dilute Russell Viper Venom Time, KCT, Kaolin Clotting Time; SCT, Silica Clotting Time).
- Figure 3.
Mechanism of action of dRVV on the coagulation cascade. The enzyme present in Russell viper venom converts FX to FXa. FXa in the presence of FVa, calcium ions and phospholipids converts prothrombin to thrombin. Thrombin converts fibrinogen to fibrin.
- Figure 4.
DRVVT screening assay. The screening assay requires a lupus sensitive reagent that contains a decreased amount of phospholipid. If a LAC is present, it will interfere with the prothrombinase complex binding to the phospholipid surface of platelets.
- Figure 5.
DRVVT confirm assay. The confirm assay requires a reagent that contains an increased concentration of phospholipid. If a LAC is present, it will neutralize the antibody facilitating binding of the prothrombinase complex onto the platelet phospholipid surface.
- Figure 6.
Silica Clotting Time assay (SCT). Micronized silica is used to activate the intrinsic pathway. LAC antibodies (in red) interfere with binding of the intrinsic tenase and prothrombinase complexes on the platelet surface.
- Figure 7.
Hexagonal Phospholipid Neutralization assay (STACLOT-LA). Patient plasma plus normal plasma are incubated in the absence of HPE tube 1) and in the presence HPE (tube 2). An APTT is performed using a LAC sensitive reagent. The clotting time of tube 1 is compared to tube 2. If a LAC is present, tube 1 minus tube 2 should be ≥ to the established cut-off.
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