DRVVT test shows 52.2 seconds. Do I need further testing for clotting?

Question

Hello doctor,

I was recently diagnosed with a blood clot in my left jugular vein and put on Eliquis (10 mg twice daily for a week, now 5 mg twice daily). I was also recently diagnosed with some sort of autoimmune disorder, but it is not clear yet which one. After being diagnosed with a blood clot, my rheumatologist performed a lupus anticoagulant panel to see if I am taking the correct blood thinners. Everything came back normal except the dRVVT, which was prolonged by 52.2 seconds. The dRVVT mix was 45 seconds, and I was told that it is negative.

I have read a lot about dRVVT testing online now, and I am concerned that I am still LA positive because the mix can show false negatives. I have also read that converting the results into a ratio is preferred. Also, my aPTT was slightly elevated (37 seconds). I have no risk factors for blood clots (normal weight, no hormonal birth control).

What is your opinion?
Do I need further testing?
How likely is it that I should be taking different blood thinners?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

If you have antiphospholipid antibody syndrome (APS), then your anti-cardiolipin antibody or lupus anticoagulant should be positive. Additionally, in APS, the raised RVT (renal vein thrombosis) is not corrected by adding normal plasma. So, the chance of lupus or APS seems to be less in your case. I suggest you investigate with a full coagulation profile workup, including coagulation factor assay and factor V estimation as well.

You have been given Apixaban, which is a very good drug for patients with thrombosis (blood clot formation). Kindly continue its intake as suggested by your doctor.

Follow your hematologist's advice and discuss all these.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.