Clinical Correlation of Positive Lupus Anti-Coagulant Cases: A Cross-Sectional Study

Abstract

Objective: To evaluate the clinical profile of lupus anticoagulant–positive patients and to determine the association between LA ratio levels and clinical manifestations.

Methodology: This cross-sectional descriptive study was conducted between September 2025 and January 2026 at Chughtai Institute of Pathology, Lahore. A total of 138 patients aged 8–90 years undergoing LA testing were included. Lupus anticoagulant was detected using a two-step dilute Russell viper venom time (DRVVT)–based screening and confirmatory assay. Results were interpreted using LA1/LA2 ratios and categorized as strongly positive (>2.0), moderately positive (1.5–2.0), weakly positive (1.2–1.5), or borderline (1.0–1.2). Clinical data were extracted from patient records.

Results: Of the 138 LA-positive cases, 59% were female. Strongly positive LA ratios were observed in 26 cases, moderately positive in 28, and weakly positive in 82 cases. Venous thrombosis was the most frequent clinical manifestation, particularly among strongly positive cases (50%). Recurrent miscarriages and arterial events, including stroke and ischemic heart disease, were also noted. Among weakly positive cases, 31% were asymptomatic.

Conclusion: LA positivity is associated with a broad spectrum of clinical manifestations, with venous thrombosis being the most common. Weakly positive LA results may be clinically silent, emphasizing the importance of correlating laboratory findings with clinical context and follow-up to exclude transient or false positivity.