Lupus Anticoagulant

Lupus anticoagulants are antibodies against substances in the lining of cells. These substances prevent blood clotting in a test tube. They are called phospholipids. People with antibodies to phospholipids (aPL) may have a very high risk of forming blood clots. They attack phospholipids, which are essential components of cell membranes. LAs are associated with an immune system disorder known as antiphospholipid syndrome.

Lupus anticoagulants can increase the risk of blood clots. However, antibodies can also be present and not lead to a clot.

Normal values range from 20 to 39 GPL or MPL units.

SYMPTOMS:

If you develop a blood clot in one of your arms or legs, symptoms may include:

• swelling in your arm or leg
• redness or discoloration in your arm or leg
• difficulty breathing
• pain/ numbness in your arm or leg

A blood clot in the area of your heart or lungs may cause:

• chest pain
• excessive sweating
• breathing difficulties
• fatigue, dizziness, or both

Blood clots in your stomach or kidneys may lead to:

• belly pain
• thigh pain
• nausea
• diarrhea or bloody stool
• fever

Blood clots can be life-threatening if they aren’t treated promptly.

CAUSES:

Most often, lupus anticoagulants and aPL are found in people with diseases such as systemic lupus erythematosus (SLE).

Lupus anticoagulants and aPL may also occur if:

• you take medicines such as phenothiazines, phenytoin, hydralazine, quinine, or the antibiotic amoxicillin.
• you have a condition such as inflammatory bowel disease (Crohn disease and ulcerative colitis), infections, or certain kinds of tumors.

Some people have no risk factors for this condition.

TREATMENT:

LUPUS ANTICOAGULANT OR APL

Often, you will not need treatment if you do not have symptoms or if you have never had a blood clot in the past.

Take the following steps to help prevent blood clots from forming:

• Avoid most birth control pills or hormone treatments for menopause (women).
• DO NOT smoke or use other tobacco products.
• Get up and move around during long plane flights or other times when you have to sit or lie down for extended periods.
• Move your ankles up and down when you cannot move around.

You will be prescribed blood-thinning medicines (such as heparin and warfarin) to help prevent blood clots:

• After surgery
• After a bone fracture
• With active cancer
• When you need to set or lie down for long periods of time, such as during a hospital stay or recovering at home

You may also need to take blood thinners for 3 to 4 weeks after surgery to lower your risk of blood clots.

ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS)

In general, you will need long-term treatment with a blood thinner for a long time if you have the APS. Initial treatment may be heparin, either unfractionated or low-molecular heparin. These medicines are given by injection.

In most cases, warfarin (Coumadin), which is given by mouth, is then started. It is necessary to monitor the level of anticoagulation frequently. This is most often done using the INR test.

If you have APS and become pregnant, you will need to be followed closely by a provider expert in this condition. You will not take warfarin during pregnancy, but will be given low-molecular weight heparin instead.

If you have SLE and APS your provider will also recommend that you take hydroxychloroquine.

Also Known As: LA, LAC, Lupus Anticoagulant Panel, Lupus Inhibitor, LA Sensitive PTT, PTT-LA, Dilute Russell Viper Venom Test, DRVVT, Modified Russell Viper Venom Test, MRVVT

Formal Name: Lupus Anticoagulant