Lupus anticoagulant: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
ClaireLewis (talk | contribs) No edit summary |
||
| Line 6: | Line 6: | ||
==Clinical Features== | ==Clinical Features== | ||
*Recurrent arterial/[[venous thrombosis|venous thromboembolism]] | *Recurrent [[arterial thrombosis|arterial]]/[[venous thrombosis|venous thromboembolism]] | ||
*Recurrent [[miscarriage|fetal loss]] | *Recurrent [[miscarriage|fetal loss]] | ||
| Line 23: | Line 23: | ||
===Pregnancy=== | ===Pregnancy=== | ||
''Miscarriage is common'' | ''[[Miscarriage]] is common'' | ||
*Prophylaxis for most women | *Prophylaxis for most women | ||
*Patients with pregnancy loss | *Patients with pregnancy loss | ||
**Prophylactic heparin and low-dose [[ASA]] | **Prophylactic [[heparin]] and low-dose [[ASA]] | ||
*Patients with history of thrombosis | *Patients with history of thrombosis | ||
**Therapeutic heparin | **Therapeutic [[heparin]] | ||
===Prophylaxis=== | ===Prophylaxis=== | ||
*Eliminate risk factors (OCPs, smoking, hypertension and HL) | *Eliminate risk factors (OCPs, smoking, hypertension and HL) | ||
*Low-dose ASA | *Low-dose [[ASA]] | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 04:45, 1 October 2019
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
Clinical Features
- Recurrent arterial/venous thromboembolism
- Recurrent fetal loss
Differential Diagnosis
Coagulopathy
Platelet Related
- Too few
- Nonfunctional
Factor Related
- Acquired (Drug Related)
- Warfarin (Coumadin)
- Unfractionated heparin
- Low molecular weight heparin (i.e. enoxaparin (Lovenox), dalteparin)
- Factor Xa Inhibitors (e.g. rivaroxaban, apixaban, fondaparinux, edoxaban)
- Direct thrombin inhibitors (e.g. dabigatran, argatroban, bivalirudin)
- Illness induced
- Genetic
Evaluation
Management
- Thrombosis (e.g. extremity phlebitis or dural sinus vein thrombosis)
Pregnancy
Miscarriage is common
- Prophylaxis for most women
- Patients with pregnancy loss
- Patients with history of thrombosis
- Therapeutic heparin
Prophylaxis
- Eliminate risk factors (OCPs, smoking, hypertension and HL)
- Low-dose ASA