Which test is used to detect lupus anticoagulants in suspected antiphospholipid syndrome?

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Lupus anticoagulants are antiphospholipid antibodies that interfere with phospholipid-dependent steps of coagulation. To detect them, a test that is highly sensitive to this interference is used. The diluted Russell viper venom test directly exploits this mechanism: venom activates coagulation factors in a phospholipid-dependent way, so the presence of lupus anticoagulants lengthens the clotting time. This test is typically followed by a confirmatory step using excess phospholipid or a phospholipid-neutralization approach to show that the prolongation is specifically due to antiphospholipid antibodies. Other common tests like the activated partial thromboplastin time can be prolonged for many reasons and are not specific for lupus anticoagulants; prothrombin time and D-dimer do not detect lupus anticoagulants.