Complications of oral contraceptives and antiphospholipid antibodies: reply to the letter by bruneau et a1

Contraceptive practices in women with systemic lupus erythematosus and/or antiphospholipid syndrome: What advice should we be giving?

“…15 Thromboses in young women using hormonal contraception often prompts investigation for underlying thrombophilias and many women with APS are diagnosed in this way. 16,17 The background incidence of thromboses in young, non-pregnant women with APS without previous thromboses and not using any hormonal contraception is approximately 5% per patient year. 18,19 Some groups report no increased incidence of thromboembolic disease in women with raised aPL taking low dose COCP.…”

Rôle des estrogènes dans le lupus érythémateux systémique

“…Il a été également constaté que les pilules estroprogestatives de troisième généra-tion semblent entraîner un risque thrombotique veineux augmenté par rapport aux pilules estroprogestatives dites de deuxième génération [41]. L'usage de la pilule estroprogestative est donc totalement contre-indiqué chez des patientes lupiques ayant un anticoagulant circulant ou une thrombophilie.…”

Primary Antiphospholipid Antibody Syndrome and Microscopic Polyarteritis in the Puerperium: A Case Report

“…strong association between oral contraceptives and anti phospholipid antibodies has not been demonstrated. Nev ertheless, there are reports of oral contraceptives precip itating clinical thromboses in patients with antiphospholi pid antibodies [1,19]. Estrogen administration may increase levels of the pituitary hormone prolactin [20,21], and both estrogen and prolactin are immunostimulatory [22].…”