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Lupus anticoagulantsDefinition Lupus anticoagulants are antibodies against phospholipids (a group of substances in cell membranes), which inhibit blood clotting in a test tube, but may be associated with a higher risk of clotting in people who have them in their blood. Causes, incidence, and risk factors Lupus anticoagulants are found in people with autoimmune diseases, such as systemic lupus erythematosis (SLE) and also in those taking certain medications, such as phenothiazines, phenytoin, dilantin, hydralazine, quinine, amoxicillin, and oral contraceptives. They may also be present in patients with inflammatory bowel disease, infections, and some tumors. Some people with these antibodies have no clear, predisposing factor. In some cases, the condition is associated with an increased risk of blood clots, and it may be the cause of recurrent miscarriages. Symptoms
The condition can also occur with no symptoms. Signs and tests
Treatment No treatment is required in the absence of symptoms. If clots occur, patients should be anticoagulated with heparin followed by warfarin. Higher-than-usual doses of warfarin may be required. Steroids are sometimes effective in decreasing the level of antibody, but it is not clear whether this decreases clotting risk. Expectations (prognosis) The outcome is usually good with appropriate therapy. Some patients have difficult-to-control clots, with recurrent symptoms. Complications Calling your health care provider Call your health care provider if you notice symptoms of clot -- swelling or redness in the leg, shortness of breath, or pain, numbness and pallor in an extremity. Prevention Awareness of risk factors may allow early diagnosis. Prevention may not be possible. References Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005. Illustrations
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