Heterogeneity of Russell's viper venom affects the sensitivity of the dilute Russell's viper venom time to lupus anticoagulants. 2004

Gary W Moore, and Geoffrey F Savidge
Centre for Haemostasis and Thrombosis, Haemophilia Reference Centre, St Thomas' Hospital, London, UK. gary.moore@gstt.sthames.nhs.uk

A number of studies have shown that commercial dilute Russell's viper venom time (DRVVT) reagents vary in their sensitivity for lupus anticoagulant (LA) detection. The differences in performance are considered to be predominantly due to antibody heterogeneity and a wide variation in phospholipid content, and also the techniques and clot detection methods employed. The present study compared the LA detection rates of five different Russell's viper venom (RVV) preparations using identical phospholipid reagents to assess the contribution of venom heterogeneity to LA detection by DRVVT. Initial analysis of 300 samples sent for thrombophilia screening identified 48 (16.0%) LAs by DRVVT and confirmatory tests with a single RVV reagent. Subsequent DRVVT analysis of all 300 samples using the other four venom reagents, with confirmatory tests on samples with elevated screen ratios, revealed a further 38 LAs in a variety of combinations of reagents. Only 15 of 86 (17.4%) of LAs were detected with all five RVV reagents. Significant biological variation of RVV exists due to differences between Russell's viper subspecies and a variety of environmental and physiological factors. The clear variations in diagnostic performance between alternative RVV preparations are most probably due to biological venom heterogeneity, and also differences in the manufacturing processes.

UI MeSH Term Description Entries
D007202 Indicators and Reagents Substances used for the detection, identification, analysis, etc. of chemical, biological, or pathologic processes or conditions. Indicators are substances that change in physical appearance, e.g., color, at or approaching the endpoint of a chemical titration, e.g., on the passage between acidity and alkalinity. Reagents are substances used for the detection or determination of another substance by chemical or microscopical means, especially analysis. Types of reagents are precipitants, solvents, oxidizers, reducers, fluxes, and colorimetric reagents. (From Grant & Hackh's Chemical Dictionary, 5th ed, p301, p499) Indicator,Reagent,Reagents,Indicators,Reagents and Indicators
D011517 Prothrombin Time Clotting time of PLASMA recalcified in the presence of excess TISSUE THROMBOPLASTIN. Factors measured are FIBRINOGEN; PROTHROMBIN; FACTOR V; FACTOR VII; and FACTOR X. It is used for monitoring anticoagulant therapy with COUMARINS. Quick Test,Russell's Viper Venom Time,Thrombotest,Russell Viper Venom Time,Russells Viper Venom Time,Prothrombin Times,Test, Quick,Time, Prothrombin,Times, Prothrombin
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D005188 False Negative Reactions Negative test results in subjects who possess the attribute for which the test is conducted. The labeling of diseased persons as healthy when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed) False Negative Reaction,Reaction, False Negative,Reactions, False Negative
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D014757 Viper Venoms Venoms from SNAKES of the viperid family. They tend to be less toxic than elapid or hydrophid venoms and act mainly on the vascular system, interfering with coagulation and capillary membrane integrity and are highly cytotoxic. They contain large amounts of several enzymes, other factors, and some toxins. Russell Viper Venom,Russell Viper Venoms,Russell's Viper Venom,Russell's Viper Venoms,Viperidae Venoms,Cerastes Venom,Cerastes Venoms,Egyptian Sand Viper Venom,Viper Venom,Viperotoxin,Russells Viper Venom,Russells Viper Venoms,Venom, Cerastes,Venom, Russell Viper,Venom, Russell's Viper,Venom, Viper,Venoms, Cerastes,Venoms, Russell Viper,Venoms, Russell's Viper,Venoms, Viper,Venoms, Viperidae,Viper Venom, Russell,Viper Venom, Russell's,Viper Venoms, Russell,Viper Venoms, Russell's
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D016682 Lupus Coagulation Inhibitor An antiphospholipid antibody found in association with a variety of diseases (e.g., SYSTEMIC LUPUS ERYTHEMATOSUS and ANTIPHOSPHOLIPID SYNDROME) as well as in healthy individuals. In vitro, the antibody interferes with the conversion of prothrombin to thrombin and prolongs the partial thromboplastin time. In vivo, it exerts a procoagulant effect resulting in thrombosis mainly in the larger veins and arteries. It further causes obstetrical complications, including fetal death and spontaneous abortion, as well as a variety of hematologic and neurologic complications. Lupus Anticoagulant,Lupus Anticoagulant Autoantibodies,Lupus Anticoagulant Autoantibody,Anticoagulant, Lupus,Coagulation Inhibitor, Lupus,Inhibitor, Lupus Coagulation,Anticoagulant Autoantibody, Lupus,Autoantibody, Lupus Anticoagulant
D019851 Thrombophilia A disorder of HEMOSTASIS in which there is a tendency for the occurrence of THROMBOSIS. Hypercoagulability,Hypercoagulabilities,Thrombophilias

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