Bloody Minded Episode 70 - The Wizard of Clots | In the Lab: Thrombophilia Testing I
Nov 25, 2025
Explore the fascinating world of thrombophilia testing with engaging insights from laboratory experts. Discover the nuances of lupus anticoagulant testing and how various assays differentiate between deficiencies. Learn about the biology of Protein C and S, including their functions and the intricacies of testing methods like ELISA and chromogenic assays. The discussion dives into the effects of anticoagulants on test results and debunks common myths around coagulation. Buckle up for a thrilling journey through the emerald lab!
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How Lupus Anticoagulants Work
- Lupus anticoagulants bind phospholipids and prolong clotting when phospholipid is limited in assays.
- Testing uses paired clotting assays (e.g., APTT with low vs high phospholipid) and a second assay like dRVVT for confirmation.
How Antiphospholipid Antibodies Are Measured
- Anti-cardiolipin and anti-beta-2 glycoprotein antibodies are measured with ELISA-like solid-phase assays.
- Commercial chemiluminescent bead platforms report IgG/IgM in GPL/MPL units using cardiolipin or beta-2 coated beads.
GPL/MPL Units Explained
- Anticardiolipin assays often require beta-2 glycoprotein as a cofactor for antibody binding.
- Results are reported in GPL (IgG) or MPL (IgM) units where one unit equals 1 μg/mL antibody.