title: The challenges of lupus anticoagulants.
abstract: The term "lupus anticoagulant" (LA) refers to a heterogeneous group of immunoglobulins behaving as acquired in vitro inhibitors of coagulation. These antibodies, namely anti-β2GPI and anti-prothrombin antibodies, induce the in vitro elongation of clotting time interfering with phospholipid-dependent coagulation cofactors. Positive LA is associated with thrombosis and pregnancy complications, providing one of the three laboratory criteria for the classification of the anti-phospholipid syndrome. LA is the strongest predictor of clinical events, especially when associated with other anti-phospholipid antibodies. Much more controversial is the risk conveyed by isolated and weak LA. LA detection is technically laborious, envisaging screening, mixing and confirming tests. Hopefully critical issues in LA detection, such as the interference of anticoagulants, will be overcome, in the next future.
authors.affiliation: a Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy.|b Experimental Laboratory of Immunological and Rheumatologic Researches , Istituto Auxologico Italiano , Milan , Italy.
authors.forename: Cecilia Beatrice
authors.initials: CB
authors.lastname: Chighizola
authors.affiliation: b Experimental Laboratory of Immunological and Rheumatologic Researches , Istituto Auxologico Italiano , Milan , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Raschi
authors.affiliation: c Clinical Cardiology, Thrombosis Centre, Department of Cardiac Thoracic and Vascular Science , University of Padua , Padua , Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Banzato
authors.affiliation: a Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy.|b Experimental Laboratory of Immunological and Rheumatologic Researches , Istituto Auxologico Italiano , Milan , Italy.
authors.forename: Maria Orietta
authors.initials: MO
authors.lastname: Borghi
authors.affiliation: c Clinical Cardiology, Thrombosis Centre, Department of Cardiac Thoracic and Vascular Science , University of Padua , Padua , Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.affiliation: a Department of Clinical Sciences and Community Health , University of Milan , Milan , Italy.|b Experimental Laboratory of Immunological and Rheumatologic Researches , Istituto Auxologico Italiano , Milan , Italy.|d Department of Rheumatology , Istituto Ortopedico Gaetano Pini , Milan , Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Meroni
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D010314:Partial Thromboplastin Time; D011247:Pregnancy; D011248:Pregnancy Complications; D013927:Thrombosis / Q000150:complications; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D016682:Lupus Coagulation Inhibitor; D053482:beta 2-Glycoprotein I
keywords: Anti-phospholipid syndrome; Anti-prothrombin antibodies; Anti-β2 glycoprotein I antibodies; Detection; Lupus anticoagulant; Pregnancy complications; Thrombosis