Thromb Haemost 1996; 76(02): 187-189
DOI: 10.1055/s-0038-1650551
Original Article
Schattauer GmbH Stuttgart

Deep Venous Thrombosis and Lupus Anticoagulant

A Case-control Study
Paolo Simioni
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Paolo Prandoni
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Ezio Zanon
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Maria A Saracino
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Alberta Scudeller
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Sabina Villalta
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Luigi Scarano
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Bruno Girolami
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
,
Lino Benedetti
1   Second Service of Radiology, University Hospital of Padua, Padua, Italy
,
Antonio Girolami
The Institute of Medical Semeiotics, University Hospital of Padua, Padua, Italy
› Author Affiliations
Further Information

Publication History

Received 18 January 1996

Accepted after resubmission 02 May 1996

Publication Date:
26 July 2018 (online)

Summary

Background. A definite evidence in favour of an association of deep-vein thrombosis (DVT) with lupus anticoagulant (LA) in patients free from systemic lupus erythematosus is still lacking.

Methods. In a case-control study, LA was determined in 176 consecutive outpatients who underwent phlebography because of the first episode of clinically suspected DVT of lower limbs. The association between DVT and LA was described using odds ratios (OR).

Results. Contrast venography confirmed the clinical suspicion in 59 patients (33.5%). LA was detected in 5 of the 59 patients with DVT (8.5%), and in none of the 117 subjects with normal venogram (P = 0.007). The OR for having an acute DVT in patients with LA was 10.7 (95% CI: 1.2-94.2).

Conclusions. LA is significantly associated with DVT in symptomatic patients. Further studies are needed to establish the clinical implications of this association.

 
  • References

  • 1 Triplett DA. Antiphospholipid-protein antibodies: laboratory detection and clinical relevance. Thromb Res 1995; 78: 1-31
  • 2 Long AA, Ginsberg JS, Brill-Edwards P, Johnston M, Turner C, Denburg JA, Bensen WG, Cividino A, Andrew M, Hirsh J. The relationship of antiphospholipid antibodies to thromboembolic disease in systemic lupus erythematosus: a cross-sectional study. Thromb Haemost 1991; 66: 520-524
  • 3 Abu-Shakra M, Gladman DD, Urowitz MB, Farewell V. Anticardiolipin antibodies in systemic lupus erythematosus: clinical and laboratory correlations. Am J Med 1995; 99: 624-628
  • 4 Mueh JR, Hervst KD, Rapaport SI. Thrombosis in patients with the lupus anticoagulant. Ann Intern Med 1980; 92: 156-159
  • 5 Elias M, Eldor A. Thrombosis in patients with the “lupus” type circulating anticoagulant. Arch Intern Med 1984; 144: 510-515
  • 6 Jude B, Goudemand J, Dolle I, Caron C, Watel A, Catherine T, Cosson A. Lupus anticoagulant and laboratory study of 100 cases. Clin Lab Haemat 1988; 10: 41-51
  • 7 Triplett DA, Brandt JT, Musgrave KA, Orr CA. The relationship between lupus anticoagulants and antibodies to phospholipid. JAMA 1988; 259: 550-554
  • 8 Mannucci PM, Canciani MT, Mari D, Meucci P. The varies sensitivity of partial thromboplastin and prothrombin time reagents in the demonstration of the lupus-like anticoagulant. Scand J Haematol 1979; 22: 423-432
  • 9 Gastineau DA, Kazmir FJ, Nichols WL, Bowie EJ. Lupus anticoagulant: an analysis of the clinical and laboratory features of 219 cases. Am J Hematol 1985; 19: 265-275
  • 10 Rosove MH, Petronella MC, Brewer RN. Antiphospholipid thrombosis: clinical course after the first thrombotic event in 70 patients. Ann Intern Med 1992; 117: 303-308
  • 11 Zanon E, Saracino MA, Simioni P, Cogo A, Fadin MA, Gavasso S, Girola-mi A. Prevalence of antiphospholipid antibodies and lupus anticoagulant in juvenile patients with objectively documented deep-vein thrombosis. Clin Appl Thrombosis/Hemostasis 1996; 2: 69-73
  • 12 Ginsberg JS, Wells PS, Brill-Edwards P, Donovan D, Moffatt K, Johnston M, Stevens P, Hirsh J. Antiphospholipid antibodies and venous thromboembolism. Blood 1995; 86: 3685-3691
  • 13 Brandt JT, Triplett DA, Alving B, Scharrer I. Criteria for the diagnosis of lupus anticoagulants: an update. Thromb Haemost 1995; 74: 1185-1190
  • 14 Exner T, Triplett DA, Tabemer D, Machin S. Guidelines for testing and revised criteria for lupus anticoagulants. Thromb Haemost 1991; 65: 320-322
  • 15 Simioni P, de Ronde H, Prandoni P, Saladini M, Bertina RM, Girolami A. Ischemic stroke in young patients with activated protein C resistance: a report of three cases belonging to three different kindreds. Stroke 1995; 26: 885-890
  • 16 Girolami A, Simioni P, Girolami B, Marchiori A, Millar DS, Bignell P, Kakkar VV, Cooper DN. A novel dysfunctional protein C (Protein C Padua 2) associated with a thrombotic tendency: substitution of Cys for Arg-1 results in a strongly reduced affinity for binding of Ca++. Br J Haematol 1993; 85: 521-527
  • 17 Lensing AWA, Büller HR, Prandoni P, Batchelor D, Molenaar AHM, Co-go A, Vigo M, Huisman PM, ten Cate JW. Contrast venography, the gold standard for the diagnosis of deep-vein thrombosis: improvement in observer agreement. Thromb Haemost 1992; 67: 8-12
  • 18 Reber G, Arvieux J, Comby E, Degenne D, de Moerloose E, Sanmarco M, Potron G. Multicenter evaluation of nine commercial kits for the quantitation of anticardiolipin antibodies. Thromb Haemost 1995; 73: 444-452
  • 19 Bongard O, Reber G, Bounameaux H, de Moerloose P. Anticardiolipin antibodies in acute venous thromboembolism. Thromb Haemost 1992; 67: 724
  • 20 Ginsburg KS, Liang MH, Newcomer L, Goldhaber SZ, Schur PH, Hen-nekens CH, Stampfer MJ. Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis. Ann Intern Med 1992; 117: 997-1002
  • 21 Prandoni P, Simioni P, Girolami A. Antiphospholipid antibodies, recurrent thromboembolism, and intensity of warfarin anticoagulation. Thromb Haemost 1996; 75: 859