Lupus anticoagulant inhibition of in vitro prostacyclin release is associated with a thrombosis-prone subset of patients

Article Abstract:

Lupus anticoagulants (a specific type of antiphospholipid antibody) are antibodies that are associated with thrombosis, or blood clot formation. Lupus anticoagulants have been identified in patients with a variety of chronic infections including acquired immunodeficiency syndrome (AIDS), as well as in patients with vascular disease. Previous reports have indicated that these antibodies may produce alterations in blood clot formation, production of prostacyclin (a protein that prevents blood clot formation) and the production of other blood proteins required for maintaining normal blood vessel function. The mechanisms by which these antibodies produce alterations in blood vessel function are unknown. In order to gain a better understanding of the role of lupus anticoagulants in thrombosis, blood samples from 26 patients with lupus anticoagulant, some of whom had a history of thrombosis and some of whom did not, were analyzed. The blood samples were evaluated for the ability to stimulate prostacyclin production, since prostacyclin is important for preventing blood clot formation. Blood from patients with previous arterial thrombosis or venous thrombosis was less effective in stimulating prostacyclin release than blood from patients without a history of blood clots. It is concluded that serum from patients with lupus anticoagulants inhibits prostacyclin release. If this occurs in the body it would imply that in diseases where lupus anticoagulants are present, a decrease in prostacyclin production may contribute to blood clot formation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Physiological aspects, Prostacyclin

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Upper extremity deep venous thrombosis: increased prevalence due to cocaine abuse

Article Abstract:

Deep venous thrombosis (a blood clot in a deep vein) of the upper extremity (UEDVT) is very rare and seems to be less serious than deep vein thrombosis of the lower extremity (LEDVT). It was noted that a large number of cases of UEDVT were diagnosed at The University of Texas Medical Branch in patients who had injected cocaine into an arm vein. From Jul 1987 through Jun 1988 records of patients diagnosed with DVT were reviewed. Twelve cases of UEDVT were noted, of which five were associated with intravenous cocaine abuse. Four out of 35 cases of LEDVT occurred in patients who took various drugs intravenously, but not in leg veins. UEDVT represented 25 percent of the total number of diagnoses of DVT during the one-year period studied. All of the affected patients were men whose blood culture tests were negative. One patient tested positively for the virus that causes AIDS. Seventy-five percent of the UEDVT patients were black, compared with 31 percent with LEDVT. None of the patients developed pulmonary emboli (clotted tissue obstructing lung vessels). Case reports are presented for the patients diagnosed with UEDVT who had injected cocaine intravenously within two days to three months prior to admission. Because of the growing use of cocaine, physicians are advised to ascertain the possibility of intravenous cocaine use in men diagnosed with UEDVT.

Cocaine abuse, Injections, Intravenous, Intravenous injections

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Arterial thrombosis associated with adjuvant chemotherapy for breast carcinoma: a cancer and leukemia Group B study

Article Abstract:

Blockage of the arteries by clots, or arterial thrombosis, has been observed with increasing frequency in women receiving chemotherapy for breast cancer. The incidence of venous thrombosis during chemotherapy has already been established. To determine the incidence of arterial thrombotic events and whether or not they are related to chemotherapy, 1,014 women receiving these treatments were monitored. This group included 113 women with clinical stage III breast cancer and 901 women with stage II breast cancer and lymph node involvement. Of the stage II group, seven patients (eight percent) experienced a thrombotic event; four were peripheral thromboses (clots in a leg artery) and three were cerebral thromboses (strokes). Six of the stage III patients (six percent) experienced a stroke. The incidence of arterial thromboses in this group of chemotherapy patients is higher than would occur in a similar group of women with or without cancer. This conclusion is based on a statistical analysis of the frequency of arterial thrombosis in patients at several major medical centers. Chemotherapy for breast cancer is associated with an increased risk of arterial thrombosis, but the mechanism of this event is not known.

Breast cancer, Chemotherapy, Cerebral embolism and thrombosis, Cerebral embolism, Cerebral thrombosis

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