Talk:Lupus anticoagulant
Lupus anticoagulant is an immunoglobulin that interferes with the body's normal clotting mechanism. Despite its name, lupus anticoagulant is not exclusively associated with lupus, but can be seen in a range of other conditions as well. The presence of lupus anticoagulant is linked to an increased risk of developing blood clots, a condition known as thrombosis.<ref name="Devreese">,
Lupus Anticoagulant (LA) testing: Performance of clinical laboratories assessed by a national survey using lyophilized affinity-purified immunoglobulin with LA activity, Thrombosis and Haemostasis, 2009, Vol. 101(Issue: 2), pp. 337–345, DOI: 10.1160/TH08-08-0547,</ref>
Understanding Lupus Anticoagulant
Lupus anticoagulant is one of the antiphospholipid antibodies, which also include anticardiolipin antibodies and anti-beta-2-glycoprotein I antibodies. These antibodies are often associated with antiphospholipid syndrome (APS), a disorder that increases the risk of clot formation. APS can occur as a primary disorder or in conjunction with other autoimmune diseases, most commonly lupus.<ref name="Giannakopoulos">,
The pathogenesis of the antiphospholipid syndrome, New England Journal of Medicine, 2013, Vol. 368(Issue: 11), pp. 1033–1044, DOI: 10.1056/NEJMra1112830,</ref>
Diagnosis of Lupus Anticoagulant
The diagnosis of lupus anticoagulant is made by laboratory testing, often when investigating a patient who has had an unexplained blood clot or recurrent miscarriages. The diagnostic process typically involves a series of coagulation tests, including the activated partial thromboplastin time (APTT) and the dilute Russell's viper venom time (dRVVT).<ref name="Moore">,
Recent guidelines and recommendations for laboratory detection of lupus anticoagulants, Thrombosis Journal, 2014, Vol. 12(Issue: 1), DOI: 10.1186/1477-9560-12-7,</ref>
Clinical Significance of Lupus Anticoagulant
Despite its anticoagulant name, the presence of lupus anticoagulant is paradoxically associated with an increased risk of blood clots rather than bleeding. This occurs because lupus anticoagulant interferes with the body's natural anticoagulant pathways. It has been associated with conditions such as deep vein thrombosis, stroke, myocardial infarction, and recurrent miscarriages, particularly in individuals with APS.<ref name="Urbanus">,
Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study, Lancet Neurology, 2009, Vol. 8(Issue: 11), pp. 998–1005, DOI: 10.1016/S1474-4422(09)70239-X,</ref>
References
Reference 28 <ref name="Devreese">Devreese, K., Hoylaerts, M. (2009). "Lupus Anticoagulant (LA) testing: Performance of clinical laboratories assessed by a national survey using lyophilized affinity-purified immunoglobulin with LA activity". Thrombosis and Haemostasis. 101(2): 337–345. doi:10.1160/TH08-08-0547.</ref> Reference 29 <ref name="Giannakopoulos">Giannakopoulos, B., Krillis, S.A. (2013). "The pathogenesis of the antiphospholipid syndrome". New England Journal of Medicine. 368(11): 1033–1044. doi:10.1056/NEJMra1112830.</ref> Reference 30 <ref name="Moore">Moore, G.W. (2014). "Recent guidelines and recommendations for laboratory detection of lupus anticoagulants". Thrombosis Journal. 12(1). doi:10.1186/1477-9560-12-7.</ref> Reference 31 <ref name="Urbanus">Urbanus, R.T., Siegerink, B., Roest, M., Rosendaal, F.R., de Groot, P.G. (2009). "Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study". Lancet Neurology. 8(11): 998–1005. doi:10.1016/S1474-4422(09)70239-X.</ref> Reference 32 <ref name="Miyakis">Miyakis, S., Lockshin , M.D., Atsumi, T., Branch, D.W., Brey, R.L., Cervera, R., Derksen, R.H., De Groot, P.G., Koike, T., Meroni, P.L. (2006). "International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)". Journal of Thrombosis and Haemostasis. 4(2): 295–306. doi:10.1111/j.1538-7836.2006.01753.x.</ref>
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Treatment and Management
Treatment primarily involves long-term anticoagulation therapy to reduce the risk of thrombotic events. This typically involves oral anticoagulants such as warfarin, or newer direct oral anticoagulants. In certain cases, such as in pregnancy, low-dose aspirin or heparin may be used.<ref name="Miyakis">,
International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS), Journal of Thrombosis and Haemostasis, 2006, Vol. 4(Issue: 2), pp. 295–306, DOI: 10.1111/j.1538-7836.2006.01753.x,</ref>
