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Relation to the Presence of Circulating Anticoagulants

Helen I. Glueck, MD; Kotagal S. Kant, MD; Mark A. Weiss, MD; Victor E. Pollak, MD; Mary Ann Miller; Macie Coots, MS

Arch Intern Med. 1985;145(8):1389-1395.

Abstract
• In an earlier report on the kidney in systemic lupus erythematosus (SLE), we described a subset of patients with circulating anticoagulants; many had glomerular and arteriolar thrombosis in the absence of necrosis and subendothelial deposits. The present study extends these observations to a larger group of patients with SLE and a circulating anticoagulant, and compares its findings with those in patients with SLE without evidence of an anticoagulant. It demonstrates (1) a higher prevalence of clinically recognizable thrombotic events in the venous and arterial circulations in patients with SLE and a detectable anticoagulant; (2) a probable shortening in life span; (3) a higher prevalence of glomerular thrombi; (4) elevated levels of factor VIII antigen and von Willebrand factor; and (5) significantly lower platelet counts and decreased in vitro platelet aggregration in response to adenosine diphosphate, epinephrine, and collagen. Since prednisone treatment often results in improvement or disappearance of a prolonged partial thromboplastin time, the test most commonly used for screening of a circulating anticoagulant, we suggest that the prevalence of this abnormality may be underestimated in patients with SLE.

(Arch Intern Med 1985;145:1389-1395)

Author Affiliations
From the Department of Pathology and Laboratory Medicine (Drs Glueck and Weiss and Mrs Coots) and Medicine (Nephrology) (Drs Kant and Pollak and Ms Miller), University of Cincinnati College of Medicine.

Footnotes
Accepted for publication Nov 12, 1984.

Reprint requests to Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center, 231 Bethesda Ave, Cincinnati, OH 45267-529 (Dr Glueck).

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