Thrombosis in systemic lupus erythematosus. Relation to the presence of circulating anticoagulants.
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 aggregation 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.
D000293:Adolescent; D000328:Adult; D001777:Blood Coagulation; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000150:complications / Q000473:pathology; D008297:Male; D010314:Partial Thromboplastin Time; D010974:Platelet Aggregation; D010976:Platelet Count; D011517:Prothrombin Time; D013921:Thrombocytopenia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology*; D014841:von Willebrand Factor / Q000032:analysis
D014841:von Willebrand Factor; D005169:Factor VIII