Lupus anticoagulants

Immunoglobulins ( IgG,IgM, IgA) directed against various protein-phospholipid complexes.

Non-specific antibody inhibitors of phospholipid surfaces that are important for coagulation.

Inhibits the formation of prothrombinase complex within the coagulation cascade.

Blocks the binding of prothrombin and factor Xa to phospholipid, which inhibits the conversion of prothrombin to thrombin and clot formation.

Reduce coagulant potential of plasma and prolong clotting time in coagulation tests based on activated partial thromboplastin time.

Failure of prolonged clotting time to correct after a 1:1 mix with normal platelet-free plasma and correction of the clotting time after addition of phospholipids confirms the diagnosis.

Detected in patients with collagen vascular disease, lymphoproliferative disorders, associated with infections, medications and in women with fetal loss.

Patients who test positive for lupus anticoagulant rarely have the criteria for the diagnosis of systemic lupus.

Found in 10% of patients of patients with SLE.

Associated with an increase in venous and arterial thromboses, thrombocytopenia, superficial thrombophlebitis, livedo reticularis, migraine headaches and, leg ulcers, cardiac valve disease and chorea.

More commonly associated with venous thrombosis and much less often with arterial disease.

DRVVT the best test the detect the lupus anticoagulant test.

When screening for lupus anticoagulants 2 or more phospholipid dependent coagulation tests are suggested-activated partial thromboplastin time, dilute Russell viper venom time, kaolin clotting time dilute prothrombin time textarin time and taipan time.

Anticoagulant therapy may interfere with the detection of lupus anticoagulant.

Occurs in approximately 10% of patients undergoing vascular surgery and is associated with a 27% incidence of early graft thromboses in vascular bypasses below the inguinal area.

In the presence of lupus anticoagulants the use of antiplatelet drugs and anticoagulation are recommended for vascular procedures.

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