What is the role of lupus anticoagulant testing in the workup of CNS lupus?

Updated: May 04, 2021
  • Author: Pradeep C Bollu, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

In addition to testing serum anticardiolipin antibody (ACLA), hematologic studies in patients with systemic lupus erythematosus (SLE) may reveal a circulating anticoagulant (originally called the lupus anticoagulant). Prolongation of the activated partial thromboplastin time (aPTT) only identifies 30% of circulating anticoagulants. Sensitivity may be enhanced by the Russell viper venom test, the kaolin clotting time, or variations using hexagonal phase phospholipids or other adsorbents.

Choojitarom et al reported that lupus anticoagulant (LA) is the strongest test to determine the risk of thrombosis in SLE-antiphospholipid antibodies (APAs, aPLs). [28] The presence of lupus nephritis and Raynaud phenomenon strongly predicts thrombosis, whereas lymphopenia and antimalarials are protective. These findings help to identify patients who may benefit from prophylactic therapy.


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