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Russell's viper venom test.

Q Do you have a reference or a procedure for the dilute Russell's viper venom tests (dRVVT)? I can find plenty of information for the old-fashioned Stypven tests, but not the dilute test that helps to detect antiphospholipid antibodies, that is, the so-called lupus anticoagulant (LAG).

A Lupus anticoagulants are antibodies that interfere with the phospholipid-dependent phases of the coagulation process. The dilute Russell's viper venom test is a phospholipid-limiting assay that helps to identify the lupus anticoagulant, which frequently poses diagnostic problems for the laboratory as well a therapeutic difficulties for the clinician. Brandt's article should help to sort out this confusing condition. [1]

In the coagulation laboratory at Duke Medical Center, they use a product marketed by American Diagnostica (Greenwich, CT). In fact, the laboratory did a thorough evaluation of this product published several years ago. Twenty-six healthy donors had negative results. A group of 42 patients with LAG were also studied. The newer formulation of the test indicated that it was more sensitive to LAG than older formulations. [2] The facility has continued to use this product, but laboratorians comment that another company, Gradipore (North Ryde, Australia), makes a similar product they feel is comparable.

John A. Koepke, MD

References

(1.) Brandt JT, Triplett DA, Alving B, et al. Criteria for the diagnosis of lupus anticoagulants: An update. Thromb Haemost. 1995;74:1185-1190.

(2.) Joyner KA, Ortel TL. A sensitive dRVVT reagent system for the detection of lupus anticoagulants. Clin Appl Thrombosis/Haemostasis. 1995; 1:73-75.
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Publication:Medical Laboratory Observer
Article Type:Brief Article
Date:Jul 1, 2000
Words:249
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