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Dilute Russell Viper Venom Time (DRVVT), with Reflex, Plasma

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Updated Test Information:

Test Description
Dilute Russell Viper Venom Time (DRVVT), with Reflex, Plasma
Synonym(s)

Dilute Russell's Viper Venom Time, Plasma; dRVVT (Dilute Russell's Viper Venom Time)

Test ID
DRVI1
General Information

Useful for:



  • Detecting and confirming or helping to exclude the presence of lupus anticoagulants (LA)

  • Identifying LA that do not prolong the activated partial thromboplastin time (APTT)

  • Evaluating unexplained prolongation of the APTT or prothrombin time clotting tests

  • Distinguishing LA from a specific coagulation factor inhibitor or coagulation factor deficiencies


Testing Algorithm:


Specimen Type

Platelet-Poor-Plasma (Citrated)

Specimen Requirements

Light-blue top (citrate)

Additional Processing Details

  • Centrifuge, remove plasma, and centrifuge plasma again

  • Freeze specimen immediately at or below -40^C, if possible

  • Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results

  • Each coagulation assay requested should have its own vial

  • See Coagulation Guidelines for Specimen Handling and Processing

Stability

Frozen: 14 days

Unacceptable Specimen Conditions

  • Gross hemolysis

  • Gross lipemia

  • Gross icterus

Limitations

  • Residual platelets in frozen-thawed plasma can decrease sensitivity and specificity of lupus anticoagulants (LA) testing (false-negative results). Specimens that are to be frozen before testing must be centrifuged twice to remove as many of the platelets as possible before freezing

  • The dilute Russell viper venom time (DRVVT) test will not detect all LA. Some LA may only be detectable by other tests such as the Staclot LA, activated partial thromboplastin time, platelet neutralization procedure, or other methods

  • Anticoagulation therapy effects such as warfarin (especially when the effect is supratherapeutic), excess heparin, direct thrombin inhibitors (DTI) (eg, dabigatran [Pradaxa], argatroban [Ancova], bivalirudin [Angiomax]), direct factor Xa inhibitors (eg, rivaroxaban [Xarelto], apixaban [Eliquis], edoxaban [Savaysa]) may result in a false-positive assay performance for LA. Clinical correlation and repeat testing remote (>1 week) from anticoagulation therapy is suggested

  • Although the DRVVT reagents contain a heparin inhibitor (Polybrene) that is sufficient for neutralization of heparin (up to 1-2 U/mL), the results may not necessarily represent what would occur if no heparin were present in the specimen. Therefore, DRVVT results from heparinized plasma should be interpreted with caution

  • DRVVT assays, when performed in isolation, will not distinguish LA from heparin or inhibitors of factors V or VIII, which may cause false-positive results of LA testing

  • Excess heparin or inhibitors of factors V or VIII may cause false-positive results of LA testing, depending on the types of coagulation testing performed

  • LA diagnosis does not have definite predictive value for associated clinical complications such as thromboembolic problems or fetal loss

  • Serum anticardiolipin antibody testing (CLPMG / Phospholipid [Cardiolipin] Antibodies, IgG and IgM, Serum) and antibeta-2 glycoprotein I (B2GMG / Beta-2 Glycoprotein 1 Antibodies, IgG and IgM, Serum) antibody testing should also be performed in conjunction with coagulation-based testing for LA to enhance detection of different types of antiphospholipid antibodies

  • Persistence of LA over time (12 weeks or more between positive testing results) is a clinically important criterion for the antiphospholipid antibody syndrome diagnosis.

Methodology

Optical Clot-Based

Estimated TAT

1-4 days

Testing Schedule

Monday-Friday

Retention

7 days

CPT Code(s)

85613

Additional Information
Minimum Sample Volume

0.5 mL

Reference Range

< 1.20

Reflex Conditions
Performing Lab

Mayo

LOINC Code(s)

15359-3