Lupus anticoagulant

By: Audiopedia

Lupus anticoagulant is an immunoglobulin that binds to phospholipids and proteins associated with the cell membrane. Lupus anticoagulant is a misnomer, as it is actually a prothrombotic agent. Lupus anticoagulant antibodies in living systems cause an increase in inappropriate blood clotting.

The name derives from their properties in vitro, since in laboratory tests, these antibodies increase aPTT. Investigators speculate that the antibodies interfere with phospholipids used to induce in vitro coagulation. In vivo, the antibodies are thought to interact with platelet membrane phospholipids, increasing adhesion and aggregation of platelets, which accounts for the in vivo prothrombotic characteristics. The condition was first described by hematologist C.

Lockard Conley. Terminology Both words in the term "lupus anticoagulant" can be misleading: Most patients with a lupus anticoagulant do not actually have lupus erythematosus, and only a small proportion will proceed to develop this disease. Patients with lupus erythematosus are more likely to develop a lupus anticoagulant than the general population. The term "anticoagulant" accurately describes its function in vitro. However in vivo, it functions as a pro-coagulant. Workup The presence of prolonged clotting times on a routine plasma test often triggers functional testing of the blood clotting function, as well as serological testing to identify common autoantibodies such as antiphospholipid antibodies. These antibodies tend to delay in-vitro coagulation in phospholipid-dependent laboratory tests such as the partial thromboplastin time. The initial workup of a prolonged PTT is a mixing test whereby the patient's plasma is mixed with normal pooled plasma and the clotting is re-assessed.

If a clotting inhibitor such as a lupus anticoagulant is present, the inhibitor will interact with the normal pooled plasma and the clotting time will remain abnormal. However, if the clotting time of the mixed plasma corrects towards normal, the diagnosis of an inhibitor such as the lupus anticoagulant is excluded; the diagnosis is a deficient clotting factor that is replenished by the normal plasma. If the mixing test indicates an inhibitor, diagnosis of a lupus anticoagulant is then confirmed with phospholipid-sensitive functional clotting testing, such as the dilute Russell's viper venom time, or the Kaolin clotting time. Excess phospholipid will eventually correct the prolongation of these prolonged clotting tests, confirming the diagnosis of a lupus anticoagulant.

Lupus anticoagulant

Treatment Treatment for a lupus anticoagulant is usually undertaken in the context of documented thrombosis, such as extremity phlebitis or dural sinus vein thrombosis. Patients with a well-documented lupus anticoagulant and a history of thrombosis should be considered candidates for indefinite treatment with anticoagulants. Patients with no history of thrombosis and a lupus anticoagulant should probably be observed. Current evidence suggests that the risk of recurrent thrombosis in patients with an antiphospholipid antibody is enhanced whether that antibody is measured on serological testing or functional testing. The Sapporo criteria specify that both serological and functional tests must be positive to diagnose the antiphospholipid antibody syndrome. Miscarriages may be more prevalent in patients with a lupus anticoagulant. Some of these miscarriages may potentially be prevented with the administration of aspirin and unfractionated heparin. The Cochrane Database of Systematic Reviews provide a deeper understanding on the subject.

Thrombosis is treated with anticoagulants. References.

No More Unicorn, with Dr Pimple Popper

(male voice)Like opal. (female voice) It's beautiful! (male voice) It's like really hard to actually get it encased in glass. (female voice) That's huge too! and that's…

Views: 8 302 323 By: Dr. Sandra Lee (aka Dr. Pimple Popper)
What to expect with a hysterectomy

Well I think one of the biggest questions that we run into that women often ask is whether they will have menopause following a hysterectomy. When we speak of a hysterectomy in medical…

Views: 7 230 By: Ohio State Wexner Medical Center
How to Enjoy the Holidays If You Aren't Feeling Well: Healthy Tips for…

Holidays often mean lots of time spend with family and friends. And also means lots of food. What should you do if you're going through cancer treatment and youre experiencing some…

Views: 208 By: ELLICSR Kitchen
Antithrombin III deficiency

Antithrombin III deficiency is a deficiency of antithrombin III. It is a rare hereditary disorder that generally comes to light when a patient suffers recurrent venous thrombosis and…

Views: 1 319 By: Audiopedia

New study vaccine manufacturers & fda regulators caught hiding risks of hpv vaccines by robert f. KENNEDY JR.AUGUST A new study published in Clinical Rheumatology exposes how vaccine…

Views: 180 By: To Your Health Body and Spirit

When the MRI tech gets up and walks out to get a doctor its pretty obvious that it’s not going to be something pleasant. Got the diagnosis of the twin to twins. Twin to twin I call…

Views: 277 By: Ohio State Wexner Medical Center