Lupus anticoagulant: clinical significance in anticardiolipin positive patients with systemic lupus erythematosus

Article Abstract:

Among patients with systemic lupus erythematosus, those with anticardiolipin antibodies (antibodies against cardiolipin, a unique fat found in cell membranes) tend to have recurrent thrombosis (clot formation), thrombocytopenia (low levels of platelets, blood cells important for clotting), and recurrent miscarriages. Many, but not all, of the patients with high levels of IgG (immunoglobulins or antibodies of the G subclass) anticardiolipin antibodies are at greatest risk of complications. These antibodies also occur in some patients with cancerous, infectious, or drug-related disorders. Other factors may be related to the subgroup of lupus patients who have anticardiolipin antibodies. Lupus anticoagulants occur in some patients with lupus erythematosus; they are antibodies that interfere with clotting and are detected by laboratory tests of clotting. Lupus anticoagulants are thought to be more strongly associated with thromboses and miscarriages than anticardiolipin antibodies. To better understand the relations between these antibodies and the disorders found in patients with lupus, three tests of clotting were used to study lupus anticoagulants. Fifty-eight patients with lupus were assessed. Increased IgG anticardiolipin antibodies were found in 17 patients, 8 of whom were positive for lupus anticoagulant in at least one test. In 13 patients, lupus anticoagulant was detected by at least one test. Eleven of the 58 patients had a clear history of thrombosis or thrombocytopenia, and this group was effectively distinguished by elevated anticardiolipin antibodies. However, other subjects without thrombosis were found to have anticardiolipin antibodies. This means that the test for anticardiolipin antibodies could identify the patients who had a history of thrombosis, but it could not distinguish the patients who did not have thrombosis. Lupus anticoagulant measured by kaolin cephalin clotting time (KCCT test) was equally able to identify the patients with a history of thrombosis and was more accurate in identifying patients without thrombosis. These results suggest that lupus anticoagulant is associated with a tendency toward thrombosis in patients who have lupus erythematosus and elevated anticardiolipin antibodies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Anticardiolipin antibodies

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Neuropsychiatric lupus erythematosus, cerebral infarctions, and anticardiolipin antibodies

Article Abstract:

Anticardiolipin antibodies (aCL) are specialized proteins that specifically bind and inactivate the phosphate-containing compound, cardiolipin. These antibodies have been detected in patients with systemic lupus erythematosus (SLE), an inflammatory disease of connective tissue. Some studies have shown that patients with aCL are at greater risk of thrombosis (blood clot formation), recurrent loss of a fetus, thrombocytopenia (decreases in blood platelets), hemolytic anemia (decrease in red blood cells), and neurological disorders. The presence of aCL has been associated with various blood clotting disorders, such as stroke, which is a loss of consciousness due to cessation of blood supply to the brain, in SLE patients. The relationship of these antibodies to central nervous system symptoms of SLE, such as headaches, seizures, and movement disorders, is not clear. Samples of blood and cerebrospinal fluid from five SLE patients with central nervous system disorders were analyzed for the presence of aCL. Antibodies to cardiolipin were detected in the blood, but not in the cerebrospinal fluid. Nuclear magnetic resonance imaging, which uses electromagnetic energy to visualize internal structures and pathology, showed that the four patients with aCL had infarct-like lesions, areas of brain tissue that had deteriorated from loss of blood supply. These findings suggest a correlation between blood levels of aCL and the presence of cerebral infarcts in SLE patients with central nervous system symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Brain, Central nervous system diseases, Antiphospholipid syndrome, Brain infarction

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Cerebrovascular accident and myocardial infarction associated with anticardiolipin antibodies in a young woman with systemic lupus erythematosus

Article Abstract:

Antibodies are specialized proteins that specifically bind and inactivate foreign particles, but may also attack body tissues and substances under abnormal conditions. Anticardiolipin antibodies specifically bind with cardiolipin, a phosphate-containing fat compound. These antibodies may be involved in producing certain symptoms in almost 61 percent of patients with systemic lupus erythematosus (SLE), a long term inflammatory disease of connective tissue. These symptoms include the presence of lupus anticoagulant (a factor that prevents blood clotting); a false positive test for syphilis; thrombocytopenia (decrease in platelet cells that are important in blood clotting); recurrent miscarriage and fetal death; and thromboembolism (formation of blood clots). A case is described of a 26-year-old woman with SLE and high levels of anticardiolipin antibodies, who developed circulation disorders in the brain and heart. The patient developed a rash over her cheeks, sensitivity to sunlight, and arthritis (inflammation of the joints). Other symptoms included high levels of antibodies against various components of the cell nucleus, including deoxyribonucleic acid (DNA); a false positive test for syphilis; and high levels of anticardiolipin antibodies. The patient developed a cerebrovascular accident (stroke) and a myocardial infarction (heart attack). The relation between anticardiolipin antibodies and these two blood flow disorders is discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Heart attack, Cerebrovascular disease, Cerebrovascular disorders

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