Clinicopathological Features of Lupus Anticoagulant: Experience at AFIP During Last Seven Years

Background: The lupus anticoagulant (LA) belongs to family of immunoglobulins,most commonly an IgG isotype. These antibodies have been identified most frequently in association withthromboembolic events, recurrent fetal loss and thrombocytopenia. The aim of the present study was toevaluate the presenting clinical and pathological features in patients LA positive presenting at AFIPRawalpindi over the period of Jan 1993 to Nov 2000. Material/Methods: Retrospective analysis of patientspresenting with positive LA was carried out. Results: 1583 suspected cases were screened for LA including1370 females and 213 males. 1024 cases presented with history of recurrent abortions, 292 with thrombosis,152 with thrombotic strokes before the age of 45 years, 52 with thrombocytopenia and 63 with miscellaneousdisorders. Out of 1024 patients tested for recurrent abortions, 130 (13%) females were positive for lupusanticoagulant. Ten (6.5%) of 152 patients presenting with strokes were found positive. Out of 292 casespresenting with thrombosis 17 (5.9%) were found positive. Conclusions: The lupus anticoagulant prevalencein Pakistani patients with recurrent fetal loss, stroke and thrombosis is statistically significant.Clinicians should be made aware of association of LA with various diseases. The successful managementof these patients depends upon close liaison with obstetricians, physicians and haematologists.

Keywords: Antiphospholipid Syndrome - diagnosis, Adult, Abortion, Habitual - immunology, Lupus Coagulation Inhibitor - analysis, Pregnancy, Stroke - immunology, Thromboembolism - immunology