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Recommendations for clinical laboratory testing for antithrombin deficiency; Communication from the SSC of the ISTH.
J Thromb Haemost 2020; 18(1):17-22JT

Abstract

Hereditary deficiency of antithrombin, a natural anticoagulant, causes a thrombophilia with a high risk for venous thromboembolism. Guidance for laboratory testing to diagnose antithrombin deficiency include the use of an activity assay for initial testing, performing an antigen test and activity-to-antigen ratio when the activity level is low, using pediatric reference ranges until the age of 6 months, excluding acquired causes of low antithrombin (e.g. liver dysfunction, proteinuria, heparin, disseminated intravascular coagulation, thrombosis, surgery) or falsely normal/elevated results (e.g. argatroban, bivalirudin, dabigatran in factor IIa-based assays; rivaroxaban, apixaban, edoxaban, but not betrixaban in Xa-based assays). Molecular testing, if available, may help determine the risk for thrombosis as this might vary among the different mutations. Moreover, it will identify mutations that can be missed by traditional activity assays. Strategies for interpreting laboratory test results are provided.

Authors+Show Affiliations

Coagulation Laboratory, Massachusetts General Hospital, Boston, MA, USA.Department of Haematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.Diagnostic Haemostasis and Thrombosis, Viapath Analytics, Guy's & St. Thomas' Hospitals, London, UK.Coagulation Department, Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK.ECAT Foundation, Voorschoten, Netherlands.Department of Pathology, Special Coagulation Laboratory, TriCore Reference Laboratories, University of New Mexico, Albuquerque, NM, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31894660

Citation

Van Cott, Elizabeth M., et al. "Recommendations for Clinical Laboratory Testing for Antithrombin Deficiency; Communication From the SSC of the ISTH." Journal of Thrombosis and Haemostasis : JTH, vol. 18, no. 1, 2020, pp. 17-22.
Van Cott EM, Orlando C, Moore GW, et al. Recommendations for clinical laboratory testing for antithrombin deficiency; Communication from the SSC of the ISTH. J Thromb Haemost. 2020;18(1):17-22.
Van Cott, E. M., Orlando, C., Moore, G. W., Cooper, P. C., Meijer, P., & Marlar, R. (2020). Recommendations for clinical laboratory testing for antithrombin deficiency; Communication from the SSC of the ISTH. Journal of Thrombosis and Haemostasis : JTH, 18(1), pp. 17-22. doi:10.1111/jth.14648.
Van Cott EM, et al. Recommendations for Clinical Laboratory Testing for Antithrombin Deficiency; Communication From the SSC of the ISTH. J Thromb Haemost. 2020;18(1):17-22. PubMed PMID: 31894660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recommendations for clinical laboratory testing for antithrombin deficiency; Communication from the SSC of the ISTH. AU - Van Cott,Elizabeth M, AU - Orlando,Christelle, AU - Moore,Gary W, AU - Cooper,Peter C, AU - Meijer,Piet, AU - Marlar,Richard, AU - ,, PY - 2019/07/23/received PY - 2019/08/31/revised PY - 2019/09/19/accepted PY - 2020/1/3/entrez KW - antigen assay KW - antithrombin KW - chromogenic assay KW - guideline KW - hypercoagulability KW - venous thromboembolism SP - 17 EP - 22 JF - Journal of thrombosis and haemostasis : JTH JO - J. Thromb. Haemost. VL - 18 IS - 1 N2 - Hereditary deficiency of antithrombin, a natural anticoagulant, causes a thrombophilia with a high risk for venous thromboembolism. Guidance for laboratory testing to diagnose antithrombin deficiency include the use of an activity assay for initial testing, performing an antigen test and activity-to-antigen ratio when the activity level is low, using pediatric reference ranges until the age of 6 months, excluding acquired causes of low antithrombin (e.g. liver dysfunction, proteinuria, heparin, disseminated intravascular coagulation, thrombosis, surgery) or falsely normal/elevated results (e.g. argatroban, bivalirudin, dabigatran in factor IIa-based assays; rivaroxaban, apixaban, edoxaban, but not betrixaban in Xa-based assays). Molecular testing, if available, may help determine the risk for thrombosis as this might vary among the different mutations. Moreover, it will identify mutations that can be missed by traditional activity assays. Strategies for interpreting laboratory test results are provided. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/31894660/Recommendations_for_clinical_laboratory_testing_for_antithrombin_deficiency L2 - https://doi.org/10.1111/jth.14648 DB - PRIME DP - Unbound Medicine ER -