Deep Venous Thrombosis and Lupus Anticoagulant

Abstract

Summary Background. A definite evidence in favour of an association of deep-vein thrombosis (DVT) with lupus anticoagulant (LA) in patients free from systemic lupus erythematosus is still lacking. Methods. In a case-control study, LA was determined in 176 consecutive outpatients who underwent phlebography because of the first episode of clinically suspected DVT of lower limbs. The association between DVT and LA was described using odds ratios (OR). Results. Contrast venography confirmed the clinical suspicion in 59 patients (33.5%). LA was detected in 5 of the 59 patients with DVT (8.5%), and in none of the 117 subjects with normal venogram (P = 0.007). The OR for having an acute DVT in patients with LA was 10.7 (95% CI: 1.2-94.2). Conclusions. LA is significantly associated with DVT in symptomatic patients. Further studies are needed to establish the clinical implications of this association.

American Heart Association/American College of Cardiology Foundation Guide to Warfarin Therapy

“…[203][204][205] Indefinite anticoagulant therapy should be considered in patients with Ͼ1 episode of idiopathic proximal vein thrombosis, thrombosis complicating malignancy, or idiopathic venous thrombosis and homozygous factor V Leiden genotype, the antiphospholipid antibody syndrome, or deficiencies of antithrombin III, protein C, or protein S. 206 -208 Prospective cohort studies indicate that heterozygous factor V Leiden or the G20210A prothrombin gene mutation in patients with idiopathic venous thrombosis does not increase the risk of recurrence. 207,209 These recommendations are based on results of randomized trials 207 that demonstrated that oral anticoagulants effectively prevent recurrent venous thrombosis (risk reduction Ͼ90%), that treatment for 6 months is more effective than treatment for 6 weeks, 206 and that treatment for 2 years is more effective than treatment for 3 months. 208 …”

An Association between Atherosclerosis and Venous Thrombosis

“…Screening for mutations and conditions associated with thrombophilia (antithrombin, protein C, or protein S deficiency; factor V Leiden; prothrombin G20210A mutation; hyperhomocysteinemia; and lupus-like anticoagulants) was left to the discretion of treating physicians and was performed according to previously described methods. [29][30][31][32][33] Carriers of thrombophilia were classified as having spontaneous or secondary thrombosis according to their clinical presentation.…”

Isolation and characterization of an antifactor V antibody causing activated protein C resistance from a patient with severe thrombotic manifestations

“…21 The enzyme-linked immunosorbent assay (ELISA) kit contains cardiolipin, anionic phospholipid, and ␤ 2 -glycoprotein I. Tests were considered positive if the values exceeded 15 phospholipid units (UPL)/mL and borderline when they were between 5 and 15 UPL/mL.…”