Lupus anticoagulant: Difference between revisions
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==Background== | ==Background== | ||
*Misnomer as it is a prothrombotic agent in-vivo (anticoagulant in-vitro), and most pts do not actually have SLE (small proportion develop disease) | |||
**SLE pts more likely to develop lupus anticoagulant | |||
*Antiphospholipid syndrome (APS), where there are directed antibodies against membrane anionic phospholipids, or their associated plasma proteins | |||
*Leads to recurrent venous/arterial thrombosis and/or fetal loss | |||
==Management== | ==Management== | ||
Revision as of 22:47, 7 January 2014
Background
- Misnomer as it is a prothrombotic agent in-vivo (anticoagulant in-vitro), and most pts do not actually have SLE (small proportion develop disease)
- SLE pts more likely to develop lupus anticoagulant
- Antiphospholipid syndrome (APS), where there are directed antibodies against membrane anionic phospholipids, or their associated plasma proteins
- Leads to recurrent venous/arterial thrombosis and/or fetal loss
Management
- PPx
- Eliminate risk factors (OCPs, smoking, HTN and HL)
- Low-dose ASA
- Thrombosis (ie Extremity phlebitis or dural sinus vein thrombosis)
- Heparin IV/SQ followed by warfarin +/- ASA
- Goal INR
- Venous 2.0-3.0
- Arterial 3.0
- Recurrent 3.0-4.0
- OB - Miscarriage is common
- PPx for most women
- Pts with pregnancy loss
- Prophylactic heparin and low-dose ASA
- Pts with h/o thrombosis
- Therapeutic heparin
See Also
Source
- Tintinalli
- UpToDate