Lupus anticoagulant: Difference between revisions
Ostermayer (talk | contribs) (Text replacement - " pts" to " patients") |
|||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Misnomer as it is a prothrombotic agent in-vivo (anticoagulant in-vitro in the lab) | *Misnomer as it is a prothrombotic agent in-vivo (anticoagulant in-vitro in the lab) | ||
*Most | *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 | *Included in Antiphospholipid syndrome (APS), where there are directed antibodies against membrane anionic phospholipids, or their associated plasma proteins | ||
**Increases aPTT | **Increases aPTT | ||
Revision as of 16:50, 21 June 2016
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
- 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
Diagnosis
Management
- Thrombosis (e.g. extremity phlebitis or dural sinus vein thrombosis)
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, HTN and HL)
- Low-dose ASA