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Encyclopedia > Lupus anticoagulant

Lupus anticoagulant (also known as lupus antibody, LA, or lupus inhibitoris) is a medical phenomenon where autoantibodies bind to phospholipids and proteins associated with the cell membrane. Since interactions between the cell membrane and clotting factors are necessary for proper functioning of the coagulation cascade, the lupus anticoagulant can interfere with blood clotting as well as in-vitro tests of clotting function. Paradoxically, lupus anticoagulants are also risk factors for thrombosis. An autoantibody is a protein manufactured by the immune system that is directed against one or more of the hosts own proteins. ... Phospholipid Two schematic representations of a phospholipid. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Coagulation is the thickening or congealing of any liquid into solid clots. ... The coagulation cascade The coagulation cascade. ... Wiktionary has a definition of: In vitro In vitro (Latin: within glass) means within a test tube, or, more generally, outside a living organism or cell. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ...


The name "lupus anticoagulant" is a misnomer. Most patients with a lupus anticoagulant do not actually have lupus erythematosus, and only a small proportion will proceed to develop this disease (which causes joint pains, skin problems and renal failure, amongst other complications). Patients with lupus erythematosus are more likely to develop a lupus anticoagulant than the general population.


Conceptually, lupus anticoagulants overlap with the antiphospholipid antibody syndrome. Antiphospholipid syndrome, or antiphospholipid antibody syndrome, is a disorder of coagulation, and causes thrombosis in both arteries and veins, as well as recurrent miscarriage. ...


Often, the lupus anticoagulant is diagnosed on asymptomatic patients by a routine blood testing prior to surgery. Patients with a lupus anticoagulant are prone to thrombosis, excess bleeding, and habitual abortion (repeated miscarriages). Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... Habitual abortion or recurrent pregnancy loss (RPL) is the occurrence of repeated pregnancies that end in miscarriage of the fetus, usually before 20 weeks of gestation. ...

Contents

Workup

The presence of prolonged fart clotting times on a routine blood test often triggers functional testing of the blood clotting function, as well as serological testing to identify common autoantibodies. This antibody has the peculiar nature of causing a delay in coagulation in phospholipid-dependent laboratory tests such as the partial thromboplastin time. Serology is a medical blood test to detect the presence of antibodies against a microorganism. ... The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT or APTT) is a performance indicator measuring the efficacy of both the intrinsic and the common coagulation pathways. ...


The initial workup of a prolonged PTT is a mixing test whereby the patient's blood is mixed with normal blood and the clotting is re-assessed. If a clotting inhibitor such as a lupus anticoagulant is present, the inhibitor will interact with the normal blood and the clotting time will remain abnormal. However, if the clotting time of the mixed blood corrects towards normal, the diagnosis of an inhibitor such as lupus anticoagulation is excluded; the diagnosis is a deficient clotting factor that is replenished by the normal blood. The mixing test is a medical laboratory study used to clarify the differential diagnosis of clotting abnormalities. ...


If the mixing test indicates an inhibitor, diagnosis of a lupus anticoagulant is then confirmed with phospholipid-sensitive functional clotting testing, such as the dilute Russell's viper venom time, or the Kaolin clotting time. Excess phospholipid will eventually correct the prolongation of these prolonged clotting tests (conceptually known as "phospholipid neutralization" in the clinical coagulation laboratory), confirming the diagnosis of a lupus anticoagulant. Phospholipid Two schematic representations of a phospholipid. ... Dilute Russells viper venom time (dRVVT) is a laboratory test for lupus anticoagulant (LA). ...


Treatment

Treatment for a lupus anticoagulant is usually undertaken in the context of documented thrombosis, such as extremity phlebitis or dural sinus vein thrombosis. Patients with a well-documented (i.e., present at least twice) lupus anticoagulant and a history of thrombosis should be considered candidates for indefinite treatment with anticoagulants. Patients with no history of thrombosis and a lupus anticoagulant should probably be observed. Current evidence suggests that most of the risk of recurrent thrombosis in patients with a antiphospholipid antibody is accountable due to the presence of anti-beta2-glycoprotein 1 antibodies and anticardiolipin antibodies, and less so from the presence of a lupus anticoagulant on functional testing. Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... Antiphospholipid syndrome, or antiphospholipid antibody syndrome, is a disorder of coagulation, and causes thrombosis in both arteries and veins, as well as recurrent miscarriage. ...


Miscarriages can be prevented with the administration of low molecular weight heparins (LMWHs), and thrombosis is treated with anticoagulants (LMWHs and warfarin).[1] In medicine, low molecular weight heparin (LMWH) is a class of medication used as an anticoagulant in diseases that feature thrombosis, as well as for prophylaxis in situations that lead to a high risk of thrombosis. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Warfarin (also known under the brand names of Coumadin, Jantoven, Marevan, and Waran) is an anticoagulant medication that is administered orally or, very rarely, by injection. ...


References

  1. ^ Dolitzky M, Inbal A, Segal Y, Weiss A, Brenner B, Carp H (2006). "A randomized study of thromboprophylaxis in women with unexplained consecutive recurrent miscarriages". Fertil Steril 86 (2): 362-6. PMID 16769056. 

External links


  Results from FactBites:
 
Lupus Anticoagulant: The Test (890 words)
Lupus anticoagulant testing is used to help determine the cause of an unexplained thrombosis, recurrent fetal loss, or a prolonged PTT test.
Lupus anticoagulant testing is ordered when a patient has had an unexplained thrombotic episode, has had recurrent miscarriages, and/or as a follow-up to a prolonged PTT test.
If a patient with a thrombosis has a lupus anticoagulant, it may be necessary to prolong and possibly increase the intensity of their anticoagulation therapy.
Lupus anticoagulant - Wikipedia, the free encyclopedia (246 words)
Lupus anticoagulant is an autoimmune disorder caused by antibodies that bind to phospholipids and proteins associated with the cell membrane.
Although it is named "lupus anticoagulant," this is a misnomer.
Furthermore, this antibody is not associated with anticoagulation, but rather is associated with thrombosis and habitual abortion (repeated miscarriage).
  More results at FactBites »

 
 

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