Lupus anticoagulant

Background

  • Misnomer as it is a prothrombotic agent in-vivo (anticoagulant in-vitro in the lab)
  • Most patients do not actually have SLE (small proportion develop disease), but SLE patients more likely to develop lupus anticoagulant
  • Included in Antiphospholipid syndrome (APS), where there are directed antibodies against membrane anionic phospholipids, or their associated plasma proteins
    • Increases aPTT
  • Leads to recurrent venous/arterial thrombosis and/or fetal loss

Clinical Features

Differential Diagnosis

Coagulopathy

Platelet Related

Factor Related

Evaluation

Management

Pregnancy

Miscarriage is common

  • Prophylaxis for most women
  • Patients with pregnancy loss
    • Prophylactic heparin and low-dose ASA
  • Patients with history of thrombosis
    • Therapeutic heparin

Prophylaxis

  • Eliminate risk factors (OCPs, smoking, hypertension and HL)
  • Low-dose ASA

Disposition

See Also

References

Authors:

Ross Donaldson