Lupus Anticoagulants and Thrombosis

Abstract

25 patients with lupus anticoagulant (LA) and a history of thrombosis are described and the cases reported in the literature with this association are reviewed. From the combined data it is concluded that the prevalence of thrombosis in patients with LA is about 30%, the thrombosis sites are the leg veins in about 66%, the cerebral arteries in 25% and the peripheral arteries in 10% of the patients. High anticardiolipin levels are associated with a higher risk, while age of less than 10 years, low prothrombin activity and a platelet count of less than 50,000/μl is associated with a lower risk of thrombosis. Heparin and oral anticoagulants are effective in the treatment and prevention of thrombosis without untoward risk of bleeding.

Transient lupus anticoagulant associated with hypoprothrombinemia and Factor XII deficiency following adenovirus infection

“…Therefore, we may assume that these children had not only lupus anticoagulants but also anti-prothrombin antibodies. In large series hypoprothrombinemia has been found in about 10% of patients with LA [12]. It is noteworthy that this association was present in all of our cases.…”

Thrombocytopenia During Pregnancy

“…This is attributed to recurrent thrombosis of the placental and decidual vessels. 29 Although some patients with APA syndrome might show bleeding tendencies due to thrombocytopenia, this disorder is usually associated with thrombotic complications rather than bleeding. Thus there is less concern in cases of low platelet count.…”

Induction of anti-phospholipid syndrome in naive mice with mouse lupus monoclonal and human polyclonal anti-cardiolipin antibodies.

“…The early association with thrombosis has been confirmed in large groups of patients (3)(4)(5)(6)(7)(8). Similarly, the relationship to recurrent fetal loss, presumably resulting from placental thrombosis and infraction, has also been highlighted.…”

“…It was found that antibodies directed against negatively charged phospholipids-cardiolipin, in particular-could be demonstrated in sera from patients with positive lupus anticoagulant tests. There appears to be a close, but not absolute, correlation between the lupus anticoagulant test and anti-cardiolipin (aCL) antibodies, and there are indications that the antibodies responsible for the lupus anticoagulant test and those reactive with cardiolipin are similar but not identical (1)(2)(3)(4)(5)(6)(7)(8).…”