The lupus anticoagulant (LA) has been described, as Winston Churchill once said, like a "riddle wrapped in a mystery inside an enigma." (1939) The name anticoagulant leads one to believe a patient with this diagnosis would have bleeding tendencies, when in reality these patients are prone to thrombosis. This is a complicated disorder that requires an algorithmic approach to laboratory testing. Many laboratories see the presence of lupus anticoagulants due to prolonged screening tests resulting in what seems like unnecessary workups or delayed surgery. It is important for clinicians and laboratory professionals to work together to decide what screening and confirmatory testing is best for their patients.
This course discusses the clinical characteristics, diagnosis and treatment for patients with the lupus anticoagulant. Included is the impact of laboratory reagents in screening for the disorder, the importance of pre-analytical variables, sample processing and testing options. In addition the relationship between the Antiphospholipid Syndrome (APS) and the presence of lupus anticoagulants is addressed.