title: Acquired hypoprothrombinaemia and lupus anticoagulant: response to steroid therapy.
abstract: An iliac crest bone marrow aspiration in a 24-year-old man was followed by severe haemorrhage into the iliopsoas muscle. A lupus anticoagulant and severe hypoprothrombinaemia, as well as clinical and laboratory pointers to suggest the presence of a systemic lupus erythematosus-like syndrome, were demonstrated. Therapy with prednisone was commenced following recurrent severe epistaxis. His prothrombin time, activated partial thromboplastin time and prothrombin activity improved promptly and his bleeding ceased. The lupus anticoagulant is commonly encountered in the laboratory, but acquired hypoprothrombinaemia is extremely rare. The condition is reviewed and its treatment discussed.
authors.affiliation: Department of Medicine, University of Cape Town, South Africa.
authors.forename: R J
authors.initials: RJ
authors.lastname: Hift
authors.forename: A R
authors.initials: AR
authors.lastname: Bird
authors.forename: B D
authors.initials: BD
authors.lastname: Sarembock
mesh_terms: D000328:Adult; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology*; D004844:Epistaxis / Q000209:etiology; D006801:Humans; D007020:Hypoprothrombinemias / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D010314:Partial Thromboplastin Time; D011241:Prednisone / Q000627:therapeutic use*
chemical_list: D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor; D011241:Prednisone