Lupus anticoagulant in systemic lupus erythematosus and its association with complications

Abstract

Background: The anti-phospholipid antibody which can occur secondary to SLE have a broad spectrum of both thrombotic and non-thrombotic manifestations. Among the three antiphospholipid antibodies, lupus anticoagulant has the strongest association with antiphospholipid syndrome (APS) and increased chance of recurrence of thrombotic events. Hence early screening of lupus anticoagulant is needed.Methods: 72 clinically diagnosed SLE patients were included. The PT, aPTT were done in all patients. The clotting time is assessed by semi-automated coagulation analyser by using dilute russell viper venom time (dRVV) screen and confirm kits. Lupus anticoagulant was considered to be positive if the screen to confirm ratio is ≥1.2. The patients were followed up for a period of 1 year at regular 3 months interval. The various complications like hemolytic anemia, thrombocytopenia, deep vein thrombosis, cerebrovascular accident/transient ischemic attack (CVA/TIA), myocardial infarction, abortions, pulmonary artery hypertension and lupus nephritis were recorded.Results: Lupus anticoagulant was positive in 38.8% among the study group. The most common thrombotic event observed was DVT (16.7%) followed by MI (11.1%) and CVA/TIA (8.3%). There is significant association between lupus anticoagulant positivity with hemolytic anemia, DVT and pulmonary artery hypertension.Conclusions: The lupus anticoagulant has the strongest association with APS in SLE patients and dRVVT is the test of choice in diagnosing APLA. Early recognition of APLA can reduce the risk of thrombotic complications and can prevent further episodes by giving adequate thromboprophylaxis to lupus anticoagulant positive patients

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