Prevention of recurrent stroke in patients with systemic lupus erythematosus or lupus anticoagulant.
Patients with systemic lupus erythematosus (SLE) or lupus anticoagulant (LA) may have antibodies, including anticardiolipin antibodies (aCL), which may be associated with stroke and a high risk of recurrent stroke. Optimum preventive treatment is uncertain. We report and analyze experience with 26 patients with SLE or LA, some of whom also had aCL, who were treated with heparin and/or warfarin, often after failure of aspirin and/or steroids to prevent cerebral ischemia. Representative summaries of cases are included. Potential mechanisms of the thrombotic tendency in these patients are reviewed. Complications of anticoagulant therapy can be serious; contraindications to this treatment are discussed. Patients with either SLE or LA who have a history of a cerebral ischemic event have a high risk of recurrent stroke, which may be ameliorated by administering anticoagulants if there are no contraindications.
From the Department of Neurology, Henry Ford Hospital, Detroit, MI, U.S.A.
N
N
Futrell
C H
CH
Millikan