Coagulation Defects in a Case of Systemic Lupus Erythematosus with Thrombocytopenia

Bonnin, J. A.; Cohen, Avraham; Hicks, N. D.

doi:10.1111/j.1365-2141.1956.tb06825.x

Cited by 27 publications

(13 citation statements)

References 13 publications

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“…Our study confirms several observations and statements from other in vestigators: (1) the inhibitor does not destroy coagulation factors nor inter mediate products [2]; (2) the inhibitory effect is more marked when weaker concentrations of thromboplastin or phospholipid are used [2,16,21]; (3) some patients also have a true factor II deficiency [2,3,8,17,24], It is shown that the inhibitor activity in our patients is not specifically directed against one or more clotting factors. Since all clotting factor assays are influenced by the inhibitor if the same accelerating phospholipid is used, we are inclined to think that the inhibitor interferes with clotting factor ad sorption on to lipid surfaces [9], probably by covering these up.…”

Section: Discussionsupporting

confidence: 89%

“…Because of the observation of antiplatelet-factor-III activity [17] and the frequently ob served false-positive serological reactions for syphilis [3,5,6,8,14,15,17,19,23], positive cephalin flocculation (Hänger) test [3,5,8,17], and positive direct antiglobulin (Coombs) test [14,15,17] associated with the presence of circulating anticoagulant in these patients, it was generally thought that these phenomena were related to the same immunological complication. F r ic k [8] also found that the blood of a new-born baby from a mother with DLE and a circulating anticoagulant not only contained anticoagulant acti vity of the same type for several weeks after birth, but also abnormal sero logic and turbidimetric tests for a longer period.…”

Section: Introductionmentioning

confidence: 99%

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Circulating Anticoagulant in Disseminated Lupus Erythematosus

Veltkamp¹,

Kerkhoven²,

Loeliger³

1973

Pathophysiol Haemos Thromb

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Seven patients, four of whom have proven DLE, are described with a circulating anticoagulant displaying antiphospholipid activity. The anticoagulant effect is decreased when the patient sample is added in a more diluted form and can be overwhelmed by a phospholipid preparation of high potency. This explains for the absence of hemorrhagic symptoms in these patients because a vast excess of platelet phospholipid is liberated during platelet plug formation. Furthermore the inhibitor does not protect against thrombosis.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Circulating Anticoagulant in Disseminated Lupus Erythematosus

Veltkamp¹,

Kerkhoven²,

Loeliger³

1973

Pathophysiol Haemos Thromb

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“…However the PT can be utilized to screen for the LA if a weak thromboplastin is used, and this fact forms the basis of the so-called dilute tissue thromboplastin assay (10)(11)(12)(13)(14)(15)(16). In this test the PT of patient and control plasma is performed by using exponential dilutions of tissue thromboplastin.…”

Section: Discussionmentioning

confidence: 99%

“…The type of tissue thromboplastin utilized in the assay does not appear to be a limiting factor, because the abnormality has been observed with dilute rabbit brain (6,lO-14), human brain (15,16), and bovine lung (12) tissue thromboplastins. The marked prolongation of the PT when dilute tissue thromboplastin is utilized appears to be specific for the L A and has not been observed in plasma from patients receiving coumarin compounds, in plasma from patients congenitally deficient in prothrombin, factor VIII, or factor IV, and in plasma containing anti-factor VIII antibody (5,6,11).…”

Section: Discussionmentioning

confidence: 99%

The lupus anticoagulant

Boxer

Ellman

Carvalho

1976

Arthritis & Rheumatism

127

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The clinical and laboratory experience with the lupus anticoagulant was reviewed in 37 patients. The anticoagulant is thought to act by blocking the activation of prothrombin by the prothrombin activator complex of factors Xa, V, and phospholipid. Although the anticoagulant has been principally associated with diseases of immune origin, 14 of the present patients had disorders not thought to be immune in nature. Eighteen patients underwent twenty-one operative procedures with only a single episode of excessive bleeding. In the authors' experience, the lupus anticoagulant is a rare cause of bleeding.Circulating anticoagulants directed against specific coagulation factors (XII, X I , I X , a n d VIII) have been sporadically reported in patients with systemic lupus erythematosus (SLE) (1-5). However the most common abnormality o f t h e coagulation system in SLE is the so-called lupus anticoagulant ( L A ) , which appears t o block the activation o f prothrombin by the prothrombin activator complex o f factors Xa, V, a n d phospholipid (6,7). T h e L A is characterized by a prolonged activated partial thromboplastin time ( P T T ) a n d by a mild to moderately prolonged prothrombin time (PT). T h e prolongation of t h e PT is greatly exaggerated when a dilute tissue thromboplastin reagent is utilized, a n d this feature forms the basis of a simple a n d specific test for t h e LA-the dilute tissue thromboplastin assay (7).During t h e past 4 years the authors have tested for t h e From

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“…17, 18]. The antibodies are mostly directed against the prothrombin activator complex, against factor VIII and against factor IX [1,4,9,13,14,17,18], In such patients se vere bleeding symptoms occur: bleeding in SLE may also be related to thrombocytopenia [1,4], which almost always is associated with the pres ence of antiplatelet antibodies [8,11]. However, some cases with anticoa gulants against factor XI [4,12] and factor XII [4,6,7] have also been reported.…”

mentioning

confidence: 99%

Circulating Anticoagulant against Factor XI and Thrombocytopenia with Platelet Aggregation Inhibition in Systemic Lupus Erythematosus

Leone¹,

Accorrà²,

Boni³

1977

Acta Haematol

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In a patient with systemic lupus erythematosus, anticoagulant activity directed against factor XI was found together with thrombocytopenia. In the serum globulin fraction, antiplatelet antibodies and an activity-inhibiting platelet aggregation could also be found. A possible correlation between the inhibition of platelet aggregation and the anticoagulant activity directed against factor XI is discussed

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Coagulation Defects in a Case of Systemic Lupus Erythematosus with Thrombocytopenia

Cited by 27 publications

References 13 publications

Circulating Anticoagulant in Disseminated Lupus Erythematosus

Circulating Anticoagulant in Disseminated Lupus Erythematosus

The lupus anticoagulant

Circulating Anticoagulant against Factor XI and Thrombocytopenia with Platelet Aggregation Inhibition in Systemic Lupus Erythematosus

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