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ISTH Lupus Anticoagulant Guidelines

From Kim Kinney at Clarian Health in Indianapolis:

Hi George. It was good to see you at the Midwest Hemostasis Symposium this year. My question stems from one of the presentations. There was a presenter from Texas, I believe, who gave a talk on multiple miscarriages. He mentioned that he had been at the recent ISTH meeting and referred to the updated guidelines. Our pathologist is going to try to convince a group of docs here at Clarian that IgA testing is not first-line testing for APA antibodies. Our pathologist is interested in talking with other docs before he presents to our group. Do you know the presenter’s contact information? Could you also refer me to the current guidelines? Thanks for the help, as always.

Hi, Kim. I believe the presenter you are asking about is Ravindra (Ravi) Sarode, MD. Click on his name for his contact information. He is a pathologist and director of Transfusion Medicine and the Hemostasis Reference Laboratory at the University of Texas Southwestern Medical Center in Dallas. At Midwest he spoke on “To Mix or Not to Mix–Is That the Question.”

The guidelines are found in Pengo V, Tripodi A, Reber G, et al. Update of the guidelines for lupus anticoagulant detection. J Thromb Haemost 2009; 7: 1737-40, which you can access by selecting the name. We’ve had a couple of discussions and aQuick Question on the guidelines, which have several controversial provisions such as recommending against the dilute prothrombin time on the basis of expert opinion. The article ends with reference to anti-cardiolipin and anti-β2 glycoprotein I antibody detection but may not be helpful to you pathologist as it does not directly address IgA testing. Geo.

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