instruction: hello doctor I was recently diagnosed with a blood clot in my left jugular vein and put on eliquis 10 my twice daily for a week now my 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 the 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 with 52 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 apt was slightly elevated 37seconds 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
output: hi if you have antiphospholipid antibody syndrome as then your anti cardiolipin antibody or lupus anticoagulant should be positive additionally in as the raised rat renal vein thrombosis is not corrected by adding normal plasma so lupus or as chance seems to be less in your case I suggest you investigate with full coagulation profile workup including coagulation factor assay and factor estimation as well you have been given apixiban which is a very good drug in thrombosis patients kindly continue its intake as suggested by your doctor follow your hematologist advise and discuss all these