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Lupus Anticoagulant Syndrome

Lupus anticoagulant disorder is an autoimmune disease. It is also known as antiphospholipid syndrome. This article provides information regarding this disease.
Dr. Sumaiya Khan
Last Updated: Jan 21, 2018
Lupus anticoagulant disorder is a condition, wherein the antibodies that are generated attack plasma proteins in the blood. Thus, it is an autoimmune disorder as these antibodies are not supposed to attack body's own cells. These antibodies fail to differentiate between foreign cells and the body's own cells, causing destruction of plasma proteins. The destruction of plasma proteins leads to high risk of clotting. This condition is more commonly seen in women as compared to men.
Causes
It is not exactly clear as to what causes lupus anticoagulant disease. The name itself is actually misleading as this disease may or may not be seen in conjunction with systemic lupus erythematosus. Other autoimmune or rheumatoid diseases may also show this syndrome. It is rightly called antiphospholipid syndrome. This is because the antibodies act against phospholipid, a cell-membrane substance. It is not exactly understood as to what instigates the complement activation. However, the complement system activation eventually leads to hypercoagulability and recurrent thrombosis, which can affect almost any organ.
Symptoms
Antiphospholipid syndrome can cause blood clots in the arteries or the veins in any organ. It can also lead to severe pregnancy-related complications. Following are some of the symptoms of this condition:
  • The most common event seen is deep vein thrombosis of the lower limbs. Thus, there is formation of a blood clot in the deep veins of the legs. This occurs when the peripheral-venous system is affected.
  • The most common arterial blood clot often leads to a stroke. When it affects the central nervous system, it can also lead to sinus thrombosis.
  • There may be a blood clot in lungs, also known as pulmonary embolism, which could lead to pulmonary hypertension.
  • Ocular changes due to lupus anticoagulant syndrome include amaurosis and retinal thrombosis.
  • If there is a blood clot in the adrenal gland, then it could lead to adrenal infarction and hemorrhage.
  • If the clot occurs in the musculoskeletal system, then it could lead to avascular necrosis of the bone.
  • In pregnant women that have been affected by antiphospholipid syndrome, miscarriages can occur before the 20th week of gestation, during which, it has been reported that even pre-eclampsia may occur. Placental infarctions, pre-term birth, and stillbirths have also been reported in women with antiphospholipid syndrome. In some babies, this syndrome may be the leading cause of mental retardation.
  • Other symptoms that may be seen include thrombocytopenia (decrease in the platelet count), heart valve disease, and livedo reticularis, headaches, migraine attacks, and oscillopsia. However, these symptoms on their own are not enough to diagnose a person with antiphospholipid syndrome.
Treatment Options
The treatment comprises administration of low-dose aspirin, which prevents intra-vessel clotting by inhibiting platelet activation. Even warfarin can be given as it also acts as an anticoagulant. This is mostly given as prophylactic treatment so as to maintain the patient's INR (international normalized ratio) between 2.0-3.0. However, this treatment is not opted for patients who do not have a history of thrombotic symptoms. In pregnant ladies, low-molecular weight heparin and low-dose aspirin are used rather than warfarin due to warfarin's teratogenic nature. In severe refractory cases, plasmapheresis is used.
This condition needs to be taken seriously because in rare cases, if this disease progresses unhindered, then it could lead to generalized thrombosis and rapid organ failure. Thus, in such cases, it is best to keep an eye out for the signs and symptoms of this disorder so as to diagnose and treat it at the earliest.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.