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Thrombophilic patterns of coagulation factors in lupus

Departments of Internal Medicine, Division of Translational Research and Clinical Epidemiology, Wayne State University, USA; Department of Obstetrics and Gynecology, Wayne State University, Detroit, USA pdhar{at}med.wayne.edu

J Andersen

Karmanos Cancer Institute, Detroit, Michigan, USA

L Essenmacher

Pediatric Prevention Research Center, Wayne State University, Detroit, USA

J Ager

Department of Family Medicine, Wayne State University, Detroit, USA

G Bentley

The Detroit Medical Center, Department Pathology, Section of Coagulation and Hemostasis, Detroit, Michigan, USA

RJ Sokol

Department of Obstetrics and Gynecology, Wayne State University, Detroit, USA; C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, USA

Our aim was to better define the coagulation abnormalities in patients with systemic lupus erythematosus who had thrombosis or high-risk clinical settings for thrombosis. Clinical and laboratory data of 111 patients with lupus referred for coagulation assessment because of thrombosis, pregnancy loss or high-risk clinical settings for thrombosis were reviewed retrospectively. Increased activity of procoagulant factors and decreased activity of anti-coagulant factors were observed well above the expected 5% prevalence. All comparisons were significant at the P < 0.001 level. Anticardiolipin antibodies were present in 70.5% of patients tested (55/78) in this high-risk group, but usually in low titres. Platelet hyperfunction was detected in the majority of patients tested (85.7%, 78/91). Hypercoagulability in lupus is complex and is better defined by assessing multiple haemostatic factors in addition to platelet function. Platelet hyperfunction contributes significantly to thrombophilia in lupus and this is the key finding of our study.

Key Words: anticardiolipin antibodies • antiphospholipid syndrome • haematologic changes • lupus anticoagulant • thrombosis

Lupus, Vol. 18, No. 5, 400-406 (2009)
DOI: 10.1177/0961203308097566


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