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Russell's viper, Daboia russelii Dilute Russell's viper venom time (dRVVT) is a laboratory test often used for detection of lupus anticoagulant (LA). It is an assessment of the time for blood to clot in the presence of a diluted amount of venom from Russell's viper (Daboia russelii), a highly venomous snake native to the Indian subcontinent and named after the herpetologist Patrick Russell.
The main indication for testing for lupus anticoagulant is a suspected antiphospholipid syndrome, whose main manifestations are blood clots in both arteries and veins as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, and severe preeclampsia.
Later on, it was found to be very sensitive to lupus anticoagulants but was only reliable when test plasmas were mixed with normal plasma in various proportions. [3] It became the preferred method for lupus anticoagulant testing after Dr. Wilhelm Lubbe showed it to be a good marker for recurrent fetal loss. [7]
Schematic representation of antibody. Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases, including syphilis, [1] antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behçet's syndrome, [2] idiopathic spontaneous abortion, [3] and systemic lupus erythematosus (SLE). [4]
Fresh normal plasma has all the blood coagulation factors with normal levels. If the problem is a simple factor deficiency, mixing the patient plasma 1:1 with plasma that contains 100% of the normal factor level results in a level ≥50% in the mixture (say the patient has an activity of 0%; the average of 100% + 0% = 50%). [3]
A coagulation blood test is used to measure and determine the blood's ability to clot and how fast it takes to clot, indicating the presence of lupus anticoagulant in the blood. An enzyme-linked immunosorbent assay (ELISA) test is done to detect anticardiolipin antibodies' presence in the blood. [ 9 ]
The Ecarin clotting time (ECT) is a test that is widely used for lupus anticoagulant testing in certain regions. Dabigatran etexilate is a direct oral thrombin inhibitor that has been approved as a substitute for warfarin in preventing stroke in patients with nonvalvular atrial fibrillation.
A subset of AHAA appear to mimic the activity of lupus anticoagulant and increase Apo-H binding to phospholipids. [5] These two activities can be differentiated by the binding to Apo-H domains, whereas binding to the 5th domain promotes that anti-coagulant activity binding to the more N-terminal domains promotes lupus anticoagulant-like activities.