Volumen: 20 # Number : 2
Publication Date : Mayo - Agosto Year: 2016
Lupus anticoagulant in patients without thrombotic
or obstetric complications
Authors: Remotti L, Grosso SH, Ingratti MF, Vera Morandini MP,
Woods AI, Bermejo EI, Sánchez-Luceros A, Meschengieser
SS, Lazzari M, Blanco AN.
Abstract: Despite lupus anticoagulant (LA) is a laboratory criterion
for antiphospholipid syndrome (APS), it can
be present in asymptomatic subjects or it can be associated
with other clinical settings.
We present a retrospective analysis of 2000 consecutive
LA assays (APTT, DRVVT), 499 of them were
performed in patients without APS clinical criteria
(thrombosis or obstetric complications). According
to SSC-ISTH criteria, LA+ was found in 27.3%
(410/1501) and 43.3% (216/499) of cases with or
without APS criteria respectively; in no-APS group,
the analysis of clinical background and laboratory
features was done.
Clinical background of LA+ cases no-APS: 18.0%
asymptomatic, 34.3% bleeding symptoms (epistaxis,
gingivorrhagia, bruising, spontaneous hematomas)
and 47.7% other clinical settings (infertility,
chronic kidney disease, autoimmune disorders,
ischemic heart disease, idiopathic thrombocytopenic purpura, among others).
Other abnormal laboratory tests in LA+ cases no-
APS with bleeding symptoms: platelet dysfunction;
low VWF:RCo and/or VWF:Ag; decrease of FVIII,
FII, FV, FVII, FXI or fibrinogen (alone or with low
platelet count or low FX), a-FV inhibitor and hyperfibrinolysis
were found in the 55.4% of the cases.
The analysis showed LA+ in an important number
of cases (216/2000) without APS criteria (1.95% in
asymptomatic cases, 3.70% in patients with bleeding
symptoms and 5.15% in cases with other clinical
settings). Those LA+ cases with bleeding symptoms
represent a particular challenge because other possible
underlying defects have to be analysed in order
to explain the clinical behaviour. The detection and
identifications of combined defects required a careful
analysis in order to achieve an accurate diagnosis,
essential for therapeutic decisions.
Key words: Lupus coagulation inhibitor,
No-antiphospholipid syndrome,
Hemorrhage.
Pages : 174 - 181
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