Article: Decreased fibrinolytic capacity and increased von Willebrand factor levels as indicators of endothelial cell dysfunction in patients with lupus anticoagulant

Over a 6-year period, 10 patients with lupus anticoagulant activity were seen. A history of thrombotic disease was found in 6 patients, but only 3 had systemic autoimmune disease. Reduced fibrinolytic activity after venous occlusion was found in 9 subjects, but only 4 had high von Willebrand factor levels. These changes were unrelated to inflammatory activity, which was ruled out by normal serum protein electrophoresis in all but one case. Human brain thromboplastin dilution test was pathological in all subjects with depressed fibrinolytic activity. These two tests may prove to be of value to single out those LA patients with highest risk for development of thromboembolic disease.

Citing Articles

Localization of the apoptosis-inducing activity of lupus anticoagulant in an annexin V-binding antibody subset.

Nakamura N, Ban T, Yamaji K, Yoneda Y, Wada Y J Clin Invest. 1998; 101(9):1951-9.

PMID: 9576760 PMC: 508782. DOI: 10.1172/JCI119889.

Fibrinolysis and coagulation abnormalities in systemic lupus erythematosus. Relationship with Raynaud's phenomenon, disease activity, inflammatory indices, anticardiolipin antibodies and corticosteroid therapy.

Doria A, Ghirardello A, Boscaro M, Viero M, Vaccaro E, Patrassi G Rheumatol Int. 1995; 14(5):207-11.

PMID: 7724997 DOI: 10.1007/BF00262299.

von Willebrand factor in plasma: a novel risk factor for recurrent myocardial infarction and death.

Jansson J, Nilsson T, Johnson O Br Heart J. 1991; 66(5):351-5.

PMID: 1747294 PMC: 1024772. DOI: 10.1136/hrt.66.5.351.

References

1.

Gastineau D, Kazmier F, Nichols W, BOWIE E . Lupus anticoagulant: an analysis of the clinical and laboratory features of 219 cases. Am J Hematol. 1985; 19(3):265-75. DOI: 10.1002/ajh.2830190308. View

2.

Mellbring G, Nilsson T, Bergsdorf N, Wallen P . Tissue plasminogen activator concentrations in major abdominal surgery. Relationship to postoperative deep vein thrombosis. Thromb Res. 1984; 36(4):331-4. DOI: 10.1016/0049-3848(84)90324-4. View

3.

Mannucci P, Canciani M, Mari D, Meucci P . The varied sensitivity of partial thromboplastin and prothrombin time reagents in the demonstration of the lupus-like anticoagulant. Scand J Haematol. 1979; 22(5):423-32. DOI: 10.1111/j.1600-0609.1979.tb00440.x. View

4.

Wiman B, Mellbring G, Ranby M . Plasminogen activator release during venous stasis and exercise as determined by a new specific assay. Clin Chim Acta. 1983; 127(2):279-88. DOI: 10.1016/s0009-8981(83)80012-6. View

5.

Angles-Cano E, Sultan Y, Clauvel J . Predisposing factors to thrombosis in systemic lupus erythematosus: possible relation to endothelial cell damage. J Lab Clin Med. 1979; 94(2):312-23. View

6.

Rustin M, Bull H, Machin S, Isenberg D, Snaith M, Dowd P . Effects of the lupus anticoagulant in patients with systemic lupus erythematosus on endothelial cell prostacyclin release and procoagulant activity. J Invest Dermatol. 1988; 90(5):744-8. DOI: 10.1111/1523-1747.ep12560947. View

7.

Freyssinet J, Cazenave J . Lupus-like anticoagulants, modulation of the protein C pathway and thrombosis. Thromb Haemost. 1987; 58(2):679-81. View

8.

Cines D, Lyss A, Reeber M, Bina M, DeHoratius R . Presence of complement-fixing anti-endothelial cell antibodies in systemic lupus erythematosus. J Clin Invest. 1984; 73(3):611-25. PMC: 425060. DOI: 10.1172/JCI111251. View

9.

Carreras L, Vermylen J . "Lupus" anticoagulant and thrombosis--possible role of inhibition of prostacyclin formation. Thromb Haemost. 1982; 48(1):38-40. View

10.

Korninger C, Lechner K, Niessner H, Gossinger H, Kundi M . Impaired fibrinolytic capacity predisposes for recurrence of venous thrombosis. Thromb Haemost. 1984; 52(2):127-30. View

11.

Nilsson T, Johnson O . The extrinsic fibrinolytic system in survivors of myocardial infarction. Thromb Res. 1987; 48(6):621-30. DOI: 10.1016/0049-3848(87)90428-2. View

Decreased Fibrinolytic Capacity and Increased Von Willebrand Factor Levels As Indicators of Endothelial Cell Dysfunction in Patients with Lupus Anticoagulant